Doutorado em Enfermagem e Saúde (FEN)

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Ação de detergentes e desinfetantes em biofilme tradicional e buildup no modelo MBEC
(Universidade Federal de Goiás, 2016-12-20) Luciano, Cristiana da Costa; Alfa, Michelle J.; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Hunt, Alessandra Marçal Agostinho; Watanabe, Evandro; Melo, Dulcelene de Souza; Teles, Sheila Araújo; Tipple, Anaclara Ferreira Veiga
INTRODUCTION: Flexible Gastrointestinal Endoscopes (FGE) are used for diagnostic and therapeutic procedures, classified as semicritical health products (HP), requiring High-Level Disinfection (HLD) processing among users. The FGE designs are complex, making it difficult to process and favor the occurrence of faults that contribute to the accumulation of organic matter on the surface of the internal channels of the endoscopes, contributing to the formation of the biofilm. OBJECTIVE: To develop a Biofilm Buildup (BBF) accumulation model, based on repeated exposure of test soil containing Entercoccus faecalis and Pseudomonas aeruginosa by means of repeated cycles of fixation and to evaluate the ability of detergents and disinfectants to destroy and remove bacteria in the Traditional Biofilm (TBF) and Buildup. MATERIALS AND METHODS: TBF was developed in MBEC ™ peg, without hydroxyapatite, and BBF, with hydroxyapatite, over a period of eight days. For the development of both biofilms, E. faecalis and P. aeruginosa, containing 8 log10, colony forming units per cubic centimeters (CFU/cm2) were used. Prolystica Enzymatic (D1), Prolystica Neutral (D2), Neodisher (D3) and Endozime (D4) were tested alone and in combination with Glutaraldehyde (GLUT), Orthophthaldehyde (OPA) and Hydrogen Peroxide Accelerator (APH) to determine if both biofilms could be removed. The removal of the traditional biofilm and buidulp, using viable bacteria count, quantification of protein and carbohydrates and by means of scanning electron microscopy (SEM) was evaluated. RESULTS: After eight days of BBF development, 6.14 log10 CFU/cm2 of E. faecalis and 7.71 log10 CFU/cm2 of P. aeruginosa were reached. None of the detergents and disinfectants have been able to remove the traditional biofilms and buildup or reduce the level of bacteria. The combination of detergents and disinfectants tested in BBF provided a reduction of 3 to 5 log10 in viable bacteria, but no combination could provide the expected reduction of l log10. Only enzyme Prolystica and Endozime removed both E. faecalis (3.90 log10 colony forming units per milliliter (CFU/mL)) and P. aeruginosa (3.96 log10 CFU/mL) in suspension bacteria. None of the detergents tested removed > 1 log10 CFU/cm2 from the bacteria within the traditional biofilm. No combination of high-level disinfectant and detergent reduced the level of both E. faecalis and P. aeruginosa from the traditional biofilm interior (3 to 5 log10 CFU/cm2). Although the combination of Endozyme and Glutaraldehyde reduced 6 log10, it did not eliminate both bacteria in the traditional biofilm. CONCLUSION: Data indicate that if TBF and BBF accumulate in the EGF channels during repeated processing cycles, neither detergents nor high level disinfectants will provide the expected level of bacterial removal or destruction. Future research using the buildup model can help develop new cleaning and disinfection methods that can prevent or eliminate the BBF within the endoscope channels.
Acidentes com material biológico entre trabalhadores da área da saúde da região metropolitana de Goiânia-GO: uma análise de 25 anos de registros
(Universidade Federal de Goiás, 2016-03-30) Neves, Zilah Cândida Pereira das; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Oliveira, Adriana Cristina de; Souza, Adenícia Custódia Silva e; Pereira, Milca Severino; Mendonça, Katiane Martins; Tipple, Anaclara Ferreira Veiga
Accidents with biological material are reportable events, health care workers (TAS), victims of these accidents may be exposed to the hepatitis B and C and HIV, among others. The aims of this study were: to analyze the epidemiology of occupational accidents with biological material among health care workers of the metropolitan area of Goiania-GO (general); describe the socio-demographic and occupational profile of health care workers, victims of occupational accidents with biological material; describe the profile of accidents with biological material among health care workers; characterize the adoption of pre-exposure behaviours related to the latest accident; identify the serological status related to hepatitis B, C and HIV in victims of occupational accidents involving biological material and source patients, and establish the demographic and employment factors associated with the occurrence of multiple accidents among health care workers of the metropolitan area of Goiania-GO. Epidemiological Cross and analytical study which included all registration records of accidents involving biological material of HCW from two sources: A - records of injured HCW in a reference hospital for notification in Goiania, from the first record in 1989 to 2010, and B - records of Sinan, including the first record in 2006 until those available at 31/12/2014. Linkage of databases was performed and data analyzed using the Statistical Package for Social Sciences (SPSS). Socio-demographic and employment variables were the predictor variables and have suffered more than one accident, the outcome. Univariate analysis was performed and variables with P<0.10 were included in a logistic regression model. Ethical precepts were followed (Approval Ethics Committees: 033/2010 and 414.258/2013). A total of 11,536 accidents were recorded from 1989 to December 2014. Of these, 9,575 (83.0%) occurred among HCW and the majority was female. It was found that 665 (7.5%) of the HCW experienced more than one accident, while 70 (0.8%) experienced three or more accidents, totaling 8,825 victims. Nursing staff, auxiliary cleaning, physician, and dental and laboratory teams were the ones who were more frequently hurted, respectively. Most of the victims had completed high school (3,719 (48.0%). Blood/serum/plasma were the biological materials found to be the most involved (6,480/67.7%), at the time of administering medications/vascular access puncture occurring in 2.759 (28.9%), and involving needles with and without lumen in 6,097 (63.7%). A total of 6,653 (75.4%) HCW were vaccinated for hepatitis B. Incomplete information on Sinan records such as, use of PPE (gloves, masks, boots and safety glasses) and serological markers (HBsAg; Anti-HBs, Anti-HCV and Anti-HIV) was found to be the major factor that hampered data analysis. Age, type of material, and organic fluid were predictors risk factor for multiple accidents involving biological material among health care workers.
Adaptação transcultural e validação do instrumento Patient Engagement in Patient Safety within Canadian Healthcare Organizations para uso no Brasil
(Universidade Federal de Goiás, 2022-05-25) Sousa, Maiana Regina Gomes de; Pomey, Marie-Pascale; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lúcia Queiroz; Sousa, Fernanda Raphael Escobar Gimenes de; Vila, Vanessa da Silva Carvalho; Freitas, Juliana Santana de
INTRODUCTION: for more than two decades, patient safety has been highlighted as a global health challenge, requiring changes and implementation of initiatives to minimize risks, prevent care failures and prevent harm to patients. Patient engagement in patient safety has been one of the strategies used in the main international recommendations to improve the quality and safety of care, making relevant the existence of instruments to evaluate this practice. OBJECTIVE: to produce the Brazilian version of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations. METHOD: methodological study involving cross-cultural adaptation and validation of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations for use in Brazil, developed in two phases. The first phase, held between January 2020 and June 2021, consisted of the cross-cultural adaptation of the instrument for the Portuguese Brazilian and followed six steps: preparation, translation, back translation, pretest with nine health organizations, review, and documentation. The second phase, held between August and November 2021, was to validate of the content of the instrument using the Delphi technique, through the evaluation of a committee of experts in two sequential rounds. The semantic, conceptual, and normative equivalence of the items of the instrument were analyzed using the Coefficient of Agreement between evaluators, being considered satisfactory values greater than or equal to 90.0%. To analyze the content validity was used the Content Validity Index (CVI) and Inter-Rater Agreement (IRA), being considered approved values greater than 0.8, for both CVI and IRA. The analyses were performed using the Software R version 4.1.2. RESULTS: in cross-cultural adaptation, 97.9% of the items of the instrument were considered equivalent by 100% of the evaluators. For the items that presented agreement less than 90%, the best solutions were discussed, until a consensus was reached. The modifications made were approved by the authors of the original instrument. In content validation, most items had CVI approved in all three aspects, with 99.3% for coverage, 95.8% for clarity and 96.1% for relevance. About the IRA, 99.0% of the items presented satisfactory values for coverage, clarity, and relevance. Items with unsatisfactory values were changed and evaluated again by the expert committee and after approval by all the instrument was concluded, available for use in Brazil with the title “Engajamento do Pacientes na Segurança do Paciente em Organizações de Saúde”. CONCLUSION: the instrument is a reliable and valid tool to investigate patient engagement strategies in patient safety implemented in Brazilian health organizations, at different levels of governance.
Adaptação transcultural e validação para uso no Brasil do instrumento Quality and Safety Education for Nurses Student Evaluation Survey
(Universidade Federal de Goiás, 2019-05-22) Freitas, Juliana Santana de; Dolansky, Mary; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lucia Queiroz; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Alves, Sergiane Bisinoto
INTRODUCTION: The development of quality and patient safety competencies in health education has been the object of study and focus of recommendations built and published in recent decades in several countries. The evaluation of the achievement of these competencies by the students is necessary, however, in Brazil there are no tools published for this purpose. The Quality and Safety Education for Nurses Student Evaluation Survey (QSEN SES) evaluates, through three scales, the knowledge, skills and attitudes of Nursing students related to the following competencies: Patient-centered care; Evidence-based practice; Teamwork and collaboration; Quality Improvement; Safety and Informatics. OBJECTIVES: To perform the cross-cultural adaptation of the QSEN SES for use in Brazil and to evaluate its initial psychometric properties. METHOD: Methodological study, developed in two phases. The first consisted of the cross-cultural adaptation of the QSEN SES instrument into Brazilian Portuguese and followed six stages: translation, synthesis, back translation, expert committee review, pre-test with 30 undergraduate Nursing students from a public university and validation by the author of the original instrument. In the second phase, the Brazilian version of the QSEN SES was applied to 130 undergraduate Nursing students from three public universities, who had already completed at least 50% of the total course workload. The construct validity and reliability of the instrument were analyzed through confirmatory factor analysis and internal consistency. The Mann-Whitney and Kruskall-Wallis tests were used to verify the possible relationship between the sociodemographic variables and the quality and safety skills and attitudes. RESULTS: The QSEN SES was cross-culturally adapted for use in Brazil, presenting good reliability (Skills scale: 0,70≥ α ≤0,94; Attitudes sale: 0,86≥ α ≤0,97). The confirmatory analysis had insufficient adjustment indices for the skills model (χ2 = 352.46, SRMR = 0.075, RMSEA = 0.084, CFI = 0.868) and for the attitudes model (χ2 = 981.02, SRMR = 0.112, RMSEA = 0.193, CFI = 0.608). There was evidence of association between skills and university and sex variables. The results of the application of the QSEN SES Br in Nursing undergraduate courses in Brazil pointed out that, in a general way, the students reported the exposure to the contents related to the quality and safety in their formation, they recognize the actions as very important, however, feel unprepared to execute them. CONCLUSION: The Brazilian version of the QSEN SES is equivalent to the original version, it is reliable, however, it is suggested new studies with a larger population sample, to confirm the validity of the construct. The application of QSEN SES in Nursing schools will allow a situational analysis of education, producing information that is fundamental for educators and managers to plan curricular reforms, innovations and changes, aligned with identified needs, sustainable, with greater potential for success and longevity.
Adesão e imunogenicidade aos esquemas ultra-acelerado e acelerado de vacinação contra hepatite B entre homens em situação de rua
(Universidade Federal de Goiás, 2019-08-29) Souza, Christiane Moreira; Souza, Sandra Maria Brunini de; http://lattes.cnpq.br/6928658354895859; Souza, Sandra Maria Brunini de; Souza, Márcia Maria de; Teles, Sheila Araújo; Oliveira, Adriana Cristina de; Minamisava, Ruth
Considering the long duration of the classic hepatitis B virus (HBV) vaccination schedule, with the common loss of vaccine follow-up, alternative schemes have been proposed for vulnerable populations. The aim of this study was to evaluate the adhesion and immunogenicity of HBV vaccine in homeless men (HSR) under the accelerated (E-UA) and accelerated (E-A) vaccination regimens. Randomized, two-arm, controlled, non-inferiority trial was performed by identifying HBV-susceptible HSR, which were allocated at a 1:1 ratio for E-UA (doses at 0, 7, and 21 days) and E-A (doses at 0, 1 and 2 months). For those who completed the proposed regimen, immunogenicity assessment was performed at 30, 60 and 90 days after the last dose of each regimen. Study approved by the Research Ethics Committee and registered in the Brazilian Clinical Trials Registry (ReBEC) platform. Of the 156 screened HSR, 67 were excluded; 35 (22.4%; 95% CI: 16.6-29.6%) for having some marker of HBV exposure (2 HBsAg/positive total anti-HBc; 15 positive isolated total anti-HBc and 18 anti-HBc/anti-HBs positive) and 32 (20.5%; 95% CI: 14.9-27.5%) for isolated immunity. Of the 89 susceptible identified, 18 (20.2%) were absent at the start of the intervention and the 71 eligible were randomized and allocated to E-UA (n= 35) and E-A (n= 36). The E-UA adherence rate was 94.3% (95% CI: 81.4 -98.4%) and the E-A rate was 63.9% (95% CI: 47.6-77.5%), and E-UA was associated with higher vaccine adherence rate (RR: 1.3; 95% CI: 1.1-1.7). In the analysis of the geometric mean titre (MGT) of anti-HBs, 30 days after the last dose of the vaccine, the group submitted to E-UA had a MGT of 147.6 mIU/mL versus 224.8 mIU/mL of those submitted to the vaccine. E-A (p-value= 0.985). After 60 days, the MGT for E-UA patients was 231.7 mIU/mL versus 211.2 mIU/mL for E-A (p-value= 0.572). After 90 days, the MGT between E-UA and E-A was 259.6 mIU/mL versus 233.1 mIU/mL (p-value= 0.548). In the analysis of adequate immune response (anti-HBs titers ≥10 mIU/mL), after 30 days, 88.0% of E-UA individuals and 94.7% of E-A individuals responded to the vaccine (p-value = 0.622). After 60 days, the response to the vaccine was similar between the E-UA and E-A groups (95.5% versus 92.9%; p-value = 1,000). After 90 days, this rate was 94.7% for the E-UA group and 100.0% for the E-A group (p-value = 1,000). The use of E-UA and E-A was effective with regard to early immunogenicity. Regarding adherence, E-UA was statistically identified as the best vaccination schedule option in this study.
Análise dos registros de curativos em prontuários de um hospital de ensino do Estado de Goiás
(Universidade Federal de Goiás, 2016-06-21) Lemos, Lucimeire Fermino; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Almeida, Alessandra Rodrigues de; Barbosa, Nelson Bezerra; Bezerra, Ana Lúcia Queiroz; Prado, Marinésia Aparecida do; Barreto, Regiane Aparecida dos Santos Soares
Health records are important for keeping effective communication among all professionals involved in the process of taking care as well as for legitimating the team actions in the face of patients and families. The records must be clear and objective because they are sources of information for judicial, research, teaching, billing and auditing issues. This study has an objective to analyze the records of procedures of Level II Curative in medical records of hospitalized patients, from the nurses’ perspective, before and after the pedagogical intervention, in a Brazilian teaching hospital in the Midwest region. It was a descriptive study with both qualitative and quantitative research and was developed in many stages. The first stage included the nurses’ profiles and the identification of the main reasons why the nursing actions were not recorded. The second stage was the analysis of the records before and after the pedagogical action, which was the third stage. At last, the nurses were interviewed about their perception of the importance of the records for billing. It was observed among the sample of nurses the predominance of women (87,2%), post-graduated (82,1%) and statuary civil servants (80,4%). Even though 53,6% of the nurses said that they do not have double employment relationships, 46,4% said they do. The nurses said that it was not possible to record the procedures due to lack of time (50%), work overload (20%), lack of human resources and access to the records (12,5%), interruptions and lack of guidance (2,5%). The objective of the intervention was to discuss the importance of health records, and specially, in relation to the level II curative. 45,2% of the nurses of this institution took part in this event. In the analysis of the records, before and after the intervention, it was possible to observe the increase of the records of the curatives (82,3%), the detailing of the quantity of curatives per patient (69,9%), the classification of the wounds (63,5%), the description of the materials used in the procedures (67,3%), and also the scheduling (74%) and the checking (71,4%). The data shows that the quantity of material used maintained still. However, there was a rise of curative prescription by the nurses (79,4%) and a fall of curative prescription by the doctors (18,3%). It was also possible to observe that the performed and not prescribed procedures or prescribed and not verified procedures, in both cases, were not billed. Nevertheless, the hospital overturn related to this procedure has an increase, from July 2015. The interviews with the nurses showed that they take the responsibility in the treatment of wounds for themselves. However, it is necessary to standardize the prescriptions and the evolutions of the procedure. The complete record of this intervention is important to safeguard the institution in case of auditing. In conclusion, nurses have an important role in recording the wound treatment. The obligation of recording should be reinforced due to the quality of the service and the profession´s visibility as well as for a better material and input control and billing.
Avaliação da funcionalidade familiar por idosos
(Universidade Federal de Goiás, 2013-03-11) Vera, Ivana; Lucchese, Roselma; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4769849E6; Nakatani, Adélia Yaeko Kyosen; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794709T6; Nakatani, Adélia Yaeko Kyosen; Alvarenga, Márcia Regina; Vila, Vanessa da Silva Carvalho; Munari, Denize Bouttelet; Sadoyama, Geraldo
Demographic and epidemiologic transitions influence the Family arrangements, making the course of life of the families dynamic and leading to intergenerationality. These factors influence several aspects of the life of the elderly, especially their family relations. To assess the family dynamic of the elderly is associated to the lack of studies on the family function in this context. Thus, the objective was to assess the family relationship of the elderly using the family APGAR and the associated factors in a capital city in the Brazilian Mid-West region. This is a cross-sectional, populationbased, epidemiological study which is part of the matrix study carried out by the Rede de Vigilância a Saúde do Idoso (REVISI -Network for Elderly Health Surveillance). The probability sample was formed by 934 elderly living in the urban area of Goiânia, Goiás, Brazil. Data were collected from November 2009 to April 2010. A standardized questionnaire was applied including socioeconomic and demographic variables, self-referred health conditions, pain, falls, and access to health services. Scales to measure functional and cognitive capacities were applied. Family APGAR index assessed the family dynamics. Scores 7 refer to Good Family Function (GFF) and scores <7 refer to Family Dysfunction (FD). The outcome variables considered were the family relations and all the other relations considered as predictor variables in the instrument. For univariate association analysis, Chisquare (c)2, or Fischer’s Exact test was used at a 5% significance level. The association magnitude was expressed by Prevalence Ratio (PR) and their respective confidence intervals (CI95%). Multiple logistic regressions were used to identify factors associated to the outcome by building the model with the predictor variables whose p values were 0.20 in the univariate analysis. When we inquired the total sample that answered the index, GFF was associated to age, education, having an income, self-refer health as bad /terrible, pain complaint osteoporosis and cancer. As for the elderly who referred family dysfunction, high dysfunction was associated to falls, and a previous episode of AMI. When the population aged 80 was assessed, GFF was associated to variables of referring bad /terrible health, osteoporosis and falls. These results characterize the family dynamics of non-institutionalized elderly regarding GFF prevalence and they point to the need to adjust the current State policies to focus on the real needs of this population stratum so that professionals understand and can help balance the family dynamics and that it can strengthen the health team that works on strategies for Family health.
Cobertura vacinal em crianças assentadas, quilombolas e ribeirinhas do estado de Goiás, nascidas entre 2010 e 2017
(Universidade Federal de Goiás, 2021-08-05) Lima, Juliana de Oliveira Roque e; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Pagotto, Valéria; Minamisava, Ruth; Pessoni, Grécia Carolina; Junqueira, Ana Luiza Neto
Vaccination is considered one of the most cost-effective and most effective measures in healthcare services. On the other hand, some population groups that live in geographic and cultural isolation have been showing low rates of vaccination. In Brazil, there are no data evaluating adherence to vaccines recommended by the National Program for the Immunization of Unified Health System, better known by the acronym SUS considering children from rural and traditional communities. Therefore, this study aimed to evaluate vaccination coverage according to the national calendar of vaccination of children for the first year of life, and their distributions in space and trends in time in children living in rural settlements, communities of quilombolas, and riverside dwellers in the state of Goiás, born from 2010 to 2017. This is an epidemiological, retrospective cohort study, carried out in 40 municipalities of Goiás, followed by an ecological study. The sample consisted of 616 children born between 2010 and 2017, residents of a settled, quilombolas or riverside dwellers community in Goiás. To calculate the vaccination coverage, the percentage of children with a complete general vaccination schedule or by the vaccine was considered, with a 95% confidence interval. In the time-series, trend analysis was estimated for communities according to mesoregions of Goiás, and for this purpose, the Prais-Winsten linear regression was used, with robust variance. Trends were classified as increasing, decreasing, or stationary, according to the p-value and regression coefficient. The spatial distribution of vaccination coverage, according to the mesoregions of Goiás, was carried out along the time-series. In total, 616 children had their vaccine data evaluated, most were male (53.7%) and belonging to the quilombolas community (54.7%). The overall vaccination coverage for the recommended vaccines during the first year of life at 12 months and at 18 months was 52.4% (CI95%: 48.5% - 56.3%) and 57.8% (CI95%: 53.9% - 61.6%), respectively. For children born in 2017, just the yellow fever vaccine and measles/mumps/rubella vaccine had vaccination coverage > 90%. According to the birth cohort from 2010 to 2017, in Goiás, of the ten vaccines evaluated, six showed an increasing trend in vaccination coverage (POLIO, 10-valent pneumococcal, human rotavirus, meningococcal, yellow fever, and measles/mumps/rubella). Considering the spatial and temporal distribution, according to the mesoregions where the communities are located, a decreasing trend for vaccination coverage was only observed in the Center Goiano mesoregion for the hepatitis B vaccine. In the North Goiano mesoregion, increasing temporal trends were observed for most vaccine coverage, the exception was for BCG and measles/mumps/rubella vaccines. Despite this, the North Goiano mesoregion was the only one in which no vaccine achieved 90% coverage in the period of birth cohort 2016/2017. The results present an unequal scenario in the access to vaccination services for rural populations and traditional Brazilians and point to the need for urgent strategies to achieve and ensure equity in health for a group with distinct traditions and characteristics of the urban population of Brazil.
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.
Desenvolvimento de liderança para enfermeiros da saúde da família com o uso da estratégia coaching em grupo
(Universidade Federal de Goiás, 2014-12-02) Rocha, Bárbara Souza; Munari, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716; Munari, Denize Bouttelet; Fortuna, Cinira Magali; Bezerra, Ana Lúcia Queiroz; Medeiros, Marcelo; Motta, Kátya Alexandrina Matos Barreto
The Family Health Strategy, reorienting considered practices in health care model, in its complexity brings an action that emphasizes teamwork, participation and social mobilization, professional autonomy and complementarity of practice and care management. In this context, the nurse has been recognized as a professional who works in leadership at all levels of management. Aware of the presence of weaknesses in academic training to develop skills essential to this task and the lack of investment in improvement programs that emphasize this theme, we aimed to analyze and implement a process of leadership development for nurses using the Family Health coaching group as a guiding tool. Action research was methodological option in the conduct of research by enabling the interaction between researcher and participants at the time of production of the survey results and focus on the change of the reality. We opted for the intervention group by enabling the exchange and learning through living with others, and the use of coaching, for goals to give the change process, defining steps. Following phases of coaching, nurses experienced the stage of the evaluation, which built a picture of the current situation experienced in leadership, pointing out difficulties in professional identity and occupation of spaces in this sphere of activity. In the grounds of personal issues and how these characteristics influence the leadership and in the formulation, the group was led to develop their leadership skills, particularly communication, feedback, and the act of delegating were discussed. Implementation concept, skills and attitudes for good leadership practices, as well as potential resources for their development have been deepened. The phase transformation nurses pointed out the changes made after the intervention and consolidation, there was strengthening of experienced change and identifying the effects of the intervention. We conclude that the qualification should focus more meaningful learning practices involving participants in the change process. Likewise, it is necessary to use innovative tools to deepen their understanding of themselves and the situation through experimentation and experience, aiming to change attitudes and behaviors in managerial practice.
Diagnósticos, intervenções e resultados de enfermagem à pessoas em tratamento hemodialítico: validação de consenso por especialistas
(Universidade Federal de Goiás, 2015-10-20) Lemes, Maria Madalena Del Duqui; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Lemes, Maria Madalena Del Duqui; http://lattes.cnpq.br/8503907944360635; Barbosa, Dulce Aparecida; Brasil, Virgínia Visconde; Munari, Denize Bouttelet; Almeida, Miriam de Abreu
INTRODUCTION: Among the health problems experienced by adult and elderly people, who have a strong impact on the quality of life, stands out chronic kidney disease (CKD). The nursing process improves the clinical practice of care in hemodialysis, however, is still in its infancy and the scope of the phenomenas described in the taxonomies of diagnoses, interventions and nursing results, as the focus on hemodialysis scenario has not yet been described. OBJECTIVES: To validate nursing diagnoses as priorities by expert nurses; Validate interventions for diagnosis identified as priority by expert nurses; Validate relevant nursing results for diagnoses identified as priority by expert nurses. METHODOLOGY: A descriptive, cross-sectional study, validation of nursing diagnoses, interventions and priority outcomes for patients with chronic kidney disease on hemodialysis people, from the NANDA-I Terminology / NIC / NOC. Participated 12 hemodialysis units that served 1788 patients and 55 nurses working. From the occupational profile of these nurses was identified 21 experts. Of these, nine validated diagnoses, interventions and nursing outcomes, through a focus group, for people with chronic kidney disease. RESULTS: There were 36 validated diagnostic, 124 interventions and 119 nursing results. Of validated nursing diagnoses, 13 are recognized more often in literature and 23, little mentioned or not mentioned. CONCLUSION: The diagnoses, interventions and nursing outcomes validated by experts in hemodialysis give visibility to a qualified clinical practice proposal for systematization of nursing care in accordance with the reality of unity.
A dimensão social do trabalho do enfermeiro na estratégia de saúde da família
(Universidade Federal de Goiás, 2014-09-12) Reis, Mary Lopes; Medeiros, Marcelo; Medeiros, Marcelo; Gottems, Leila Bernarda Donato; Munari, Denize Bouttelet; Caixeta, Camila Cardoso; Sousa, Ana Luiza Lima
The nurses’ work at primary health care requires larger view of the health-disease process considering the social health determinants. Nursing has historically recognized two dimensions of its work, the theoretical (scientific) and the practical (technical). The objectives of this research were to identify and analyze the social dimension of actions performed by nurses in the Family Health Strategy; to analyze the nurses’ understandings about the Family Health Program on the social dimension of their work; and to analyze the interdisciplinary contributions under the Family Health Strategy in the actions of the social dimension of the work of nurses. Descriptive study on qualitative approach developed in a capital of central-western Brazilian region. Data were collected with 12 nurses of the Family Health Strategy through semi-structured interviews and participant observation. Once transcribed, the interviews were subjected to thematic content analysis and discussed based on the framework of Health Promotion and Social Action Theory of Max Weber and on the observation field notes. The results were organized and discussed into five categories, as known, "rational social actions related to purpose", "social actions in the traditional way", "rational actions regarding values and affective way," "overhead and hands tied" and "demands for work in the social dimension”. Generally it shows that nurses carry out actions aimed at social field, but does not identify or systematize the social dimension of their own work. The Max Weber’s Theory of Social Action becomes possible to understand the actions performed by nurses, its impacts, limitations, misconceptions and principles that guide their practice. These allow us to conclude that there is need for development of the social dimension of nurses' work, through the insertion of this discussion from initial training to the postgraduate level in order to meet the demands of such a size in the Family Health Strategy.
Efeito da lanolina anidra comparado ao leite materno combinado à concha de proteção para tratamento da dor e do trauma mamilar em lactantes: ensaio clínico randomizado
(Universidade Federal de Goiás, 2013-04-30) Vieira, Flaviana Vely Mendonça; Mota, Dálete Delalibera Correa de Faria; http://lattes.cnpq.br/1684517331855276; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Abrão, Ana Cristina Freitas Vilhena; Almeida, Ana Maria de; Costa, Paulo Sérgio Sucasas da; Guimarães, Janaína Valadares
INTRODUCTION: Women often experience nipple trauma when they start breastfeeding, and this is one of the predictive factors of early weaning. There is no sufficient evidence to date supporting one best treatment for nipple trauma. OBJECTIVE: Assess the effect of lanolin anhydrous in the treatment of nipple pain, compared to mother’s breast milk combined with nipple protection shells during breastfeeding. METHOD: Randomized clinical trial, controlled with 100 puerperal women with nipple trauma, who had delivered at a public maternity hospital of Goiânia, Goiás, Brazil. Fifty women were randomized to group 1 and 50 to group 2. In group 1, a total of 97 breasts with nipple trauma were treated with lanolin anhydrous, and in group 2, 95 breasts with nipple trauma were treated with breast milk combined with nipple protection shells, and followed for up to 10 days. Both groups received educational instructions regarding breastfeeding. The outcome variables were: nipple trauma healing – determined by the Nipple Trauma Score (NTS) and pain in the nipple-areolar region – determined by a numerical pain scale. The research proposal was approved by the Research Ethics Committee of the University Hospital at Federal University of Goiás, and was recorded on the Brazilian Record System of Clinical Trials. Data analysis was performed using chi-square test, Fisher’s Exact Test and ANOVA MR, with significance at p<0.05. RESULTS: In the baseline assessment, the groups were homogenous in terms of sociodemographic, obstetrical and neonatal characteristics. The onset of nipple trauma was on the 2nd day postpartum, in average. Intervention was initiated on the 2nd day of nipple trauma. There was a variation of traumas, with the crust being the most frequent. Nipple depigmentation improved with time, with a difference between the groups on day 7 (p=0.013) and 10 (p=0.001). There was no difference between groups for the NTS before the intervention (p=0.642). The analysis of variance over time (ANOVA MR) indicated lower NTS in group 2 with a difference between the groups on days 3 (p=0.026), 5 (p=0.004), 7 (p<0.001) and 10 (p<0.001) of follow-up. Regarding the intensity of pain in the nipple-areolar region, a 5.5 mean was found for group 1 and 5.8 for group 2, on day 1, with no difference between the groups. The intensity of pain was smaller in group 2 compared to group 1 on days 5 (p=0.001), 7 (p<0.001) and 10 (p<0.001). CONCLUSION: Compared to lanolin anhydrous, breast milk combined with nipple protection shells proved more effective in reducing pain and healing nipple trauma in breastfeeding puerperal women.
A efetividade de escovas descartáveis e submetidas à desinfecção para a higiene bucal em pacientes ventilados mecanicamente: ensaio clínico
(Universidade Federal de Goiás, 2019-04-30) Gonçalves, Fernanda Alves Ferreira; Torres, Ieda Maria Sapateiro; http://lattes.cnpq.br/0836649494981715; Campos, Cerise de Castro; http://lattes.cnpq.br/9109822142576433; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Souza, Adenícia Custódia Silva e; Roriz, Virgílio Moreira; Melo, Dulcelene de Sousa; Tipple, Anaclara Ferreira Veiga
INTRODUCTION: Invasive ventilatory and intubated patients are dependent on the nursing team. The mechanical removal of the biofilm with toothbrush is the first option, but after single use it can be contaminated by microorganisms from the oral cavity, as well as from the external environment. The use of the brush should be associated with chemical control of chlorhexidine digluconate, which is semi-critical and requires high level disinfection or be discarded. Peracetic acid is a high-level disinfectant, but has not been tested for use on toothbrushes. AIM: To compare the effectiveness of the use of disposable toothbrushes and disinfection with peracetic acid used for oral hygiene (OH) of patients under mechanical ventilation. MATERIALS AND METHODS: Randomized-controlled clinical trial performed at an intensive care unit of a public hospital in Goiânia / GO. Data were collected from 31 patients, intubated and under mechanical ventilation, between June 2017 and August 2018. The patients were divided into Control Group (OH with disinfected brushes) and Intervention Group (HB with brushes discarded). A dental evaluation was performed on day 1. Saliva collection was performed on day 1, day 3 and day 5 for counting of colony forming units (CFU). HB was performed twice a day, for up to five days, with 0.12% CHX gel and disinfected or discarded brushes. RESULTS: At admission, patients presented poor oral hygiene, periodontal disease, periodontitis and gingivitis. Most of the participants were male, with a mean age of 59.0 ± 14.4 years and mean of 19 teeth. Throughout the days of HB there was a decreasing tendency of buccal and lingual biofilms, however, there was no significant reduction of UFC, with no difference between the groups that used disposable brushes and disinfected brushes. In relation to the bacteria isolated on the fifth day, there was homogeneity in both groups, with predominance of Pseudomonas aeruginosa, Enterococcus faecium, Klebsiella pneumoniae and Staphylococcus haemolyticus. CONCLUSIONS: There was no difference in tooth and tongue brushing, performed with single use brushes, discarded or disinfected at each use. The important thing is to brush properly, following established protocols.
Entre a proteção e a vulnerabilidade: significados atribuídos ao uso de drogas entre adolescentes de escola pública de período integral
(Universidade Federal de Goiás, 2018-07-09) Pires, Laurena Moreira; Souza, Márcia Maria de; http://lattes.cnpq.br/6954087338926237; Medeiros, Marcelo; http://lattes.cnpq.br/3009722217245952; Medeiros, Marcelo; Reis, Mary Lopes; Pedrosa, Sheila Mara; Pacheco, Leonora Rezende; Barbosa, Maria Alves
Objectives: To identify and to analyze aspects related to the relational and labor insertion of adolescents attending a full-time school; and to investigate the relationship between adolescents' social vulnerability and the abusive and harmful use of psychoactive drugs. Methodology: This is a social research, with a qualitative approach of a strategic type, developed from January 2016 to December 2017. For data collection, we used the technique of focus groups guided by a predetermined script. A total of 49 adolescents aged 15 to 19 years attending a Full-time Education Center (CEPI), located in the eastern region of Goiânia- Goiás, participated in the study. Focus groups were held in the school environment. Results and discussion: The content analysis of the participants' speeches allowed the construction of four categories of analysis: "Tell us where it came from"; "With whom you walk"; "If you study, how to work?"; "Drugs: non-parallel universe". The family, the school and the group of friends were pointed out as the main groups for the relational insertion of these subjects. The adolescents presented themselves influenced by the context of economic fragility to which their families were exposed, which, in turn, motivated that they were inserted in groups of equals in that context. The meanings attributed to the world of work involved the search for family emancipation and the acquisition of consumer items. The duality faced by the adolescents resided in the impossibility of attending to the immediate desire to enter the labor market given the insertion in a full-time school, becoming an important conflict for these subjects. On the other hand, psychoactive drugs were widely present in the social context of these adolescents, permeating the meanings attributed to their relational insertions. In this sense, even if they did not use them, they felt their effects, even capable of leading them to disaffiliation. Final considerations: Finally, it was concluded that the social vulnerability of the group of participating adolescents, and of many other Brazilians, is related to the effects of poor income distribution, and this is expressed in families because of precariousness and insecurity. insertion in work, fragility of social relations permeated and subsidized by the harmful use of psychoactive substances, as well as inefficiency of social protection institutions and the State, in this case, full-time public school.
Epidemiologia da Infecção pelo Vírus da Hepatite B em Assentamento Rural em Mato Grosso do Sul, Brasil Central
(Universidade Federal de Goiás, 2013-12-09) Rodrigues, Fabiana Perez; Teles, Sheila Araujo; http://lattes.cnpq.br/4975298732179917; Teles, Sheila Araujo; Castro, Ana Rita Coimbra Motta de; Martins, Regina Maria Bringel; Matos, Márcia Alves Dias de; Tipple, Anaclara Ferreira Veiga
Hepatitis B virus (HBV) infection has been responsible for the largest number of chronic hepatitis illness throughout the world as well as its sequelae: cirrhosis and hepatocellular carcinoma. In Brazil, a low endemic country for hepatitis B, the most of the information on this infection has been limited to urban populations. Data about hepatitis B epidemiology in rural settlement are rare. Thus, the aim of this study was to investigate the epidemiological profile of hepatitis B virus infection in individuals living in a rural settlement (Itamarati I) from Mato Grosso do Sul, Brazil. Initially a cross-sectional study was carried out. Then HBV susceptible individuals were vaccinated against HBV and their vaccine response were evaluated. Participants were recruited following a random selection of their families. All family member aged ≥ 2 years who agreed to take part into the study was recruited by signing an Informed Consent Form. Then, 10-ml-blood sample was taken for detecting HBV markers: HBsAg, anti-HBs and total anti-HBc by using commercial kits. HBsAg positive samples were retested for HBeAg and anti-Hbe markers. Hepatitis B vaccine was offered to all individuals who were identified as susceptible to infection, and quantitative detection of anti-HBs was measured after the third vaccine dose. Statistical Package for the Social Sciences – SPSS for Window 15.0 was used for processing and analyzing data. The present project was approved by the Ethics Committee from Universidade Federal de Mato Grosso do Sul – UFMS. Of all participants, 54.4% were female. The majority (59.7%) were up to 40 years old, 62.7% were married and 78.3% self-declared white. Serological markers of HBV infection were identified in 110 settlers, resulting in an overall prevalence of 24.1% (95% CI: 20.4 to 28.2). Twelve subjects (2.6%) were HBsAg-positive. In 139 (30.5%) individuals were detected only anti-HBs, suggesting previous vaccination. Multiple regression analysis showed that age, social movements and sharing personal hygiene objects were independently associated to HBV. HBV DNA was found in four samples, being classified as genotypes D (3/4) and A (1/4). From those 207 individuals identified as susceptible to HBV infection, 84 received the first vaccine dose, but only 44 complied with the full vaccine regimen. In 28 of them (63.6%) vaccine response was evaluated, and 57.1% showed protective anti-HBs titers. The results of the present study show a high prevalence of hepatitis B in the settlers studied, compared to the urban population in the Midwest Region, and difficulties for vaccination against hepatitis B in this population. These findings ratify the need of the relationship between agricultural and health services and leaders of social movements of settlers for the creation and implementation of health strategies specific to this slice of rural Brazil.
Epidemiologia da Sífilis e HIV em cortadores manuais de cana-de-açúcar: bases para ações de promoção da saúde
(Universidade Federal de Goiás, 2019-04-15) Rocha, Déborah Ferreira Noronha de Castro; Teles, Sheila Araújo; http://lattes.cnpq.br/4975298732179917; Teles, Sheila Araújo; Pinheiro, Raquel Silva; Carneiro, Megmar Aparecida dos Santos; Souza, Marcia Maria de; Souza, Sandra Maria Brunini de
In Brazil, manual cane harvesting is still common in less developed regions and is predominantly carried out by migrant seasonal workers, mainly from the Northeast of Brazil. Migration results in family isolation, remaining far from their sexual partners. This situation may favor unprotected sex and thus make them vulnerable to sexually transmitted infections (STIs), including syphilis and Human Immunodeficiency Virus (HIV). The objective of this study was to investigate the epidemiology of syphilis and HIV in cane cutters in Goiás and Paraíba. It is a cross-sectional and analytical study carried out from February to September 2016, in the states of Goiás and Paraíba, in five sugar-alcohol plants. A total of 937 cane cutters participated in the study. All were interviewed and tested for serological markers of HIV (anti-HIV 1 and 2) and syphilis (anti-T.pallidum) by the rapid test (TR). The samples were positive for anti-T. pallidum (syphilis in life) were retested by VDRL (active syphilis). All of them were male, ranging in age from 18 to 67 years and almost half (47.4%) had up to four years of study. The majority were married or had a stable union (77.5%), had no prison history (90.4%) and reported an occupational accident (53.4%). A state analysis showed a higher proportion of sugarcane cutters in Goiás that reported multiple sexual partners, which consistently used condoms during sexual intercourse, consumed alcoholic beverages and cocaine (p <0.05). On the other hand, the frequency of homosexual relationships was higher in Paraiba cutters (p <0.05). A global prevalence of anti-HIV-1 of 0.3% (95% CI: 0.1-1.0), syphilis in life of 2.4% (95% CI: 1.6-3.6) and active syphilis of 1.2% (95% CI: 0.6-2.1). The variables religion and marijuana consumption were independently associated with syphilis in life. However, the first variable was shown as a protective factor (adjusted OR: 0.3, 95% CI: 0.1-0.8), and the second was risk-adjusted (adjusted OR: 2.94, 95% CI: 1,1-7,7). The results of this study show sociodemographic and behavioral differences between Goiás and Paraíba sugarcane cutters and the circulation of syphilis and HIV-1 in this impoverished population that has the potential for viral dissemination. The agreement of the public health services with sugar and alcohol industries to carry out prevention and health promotion actions in sugarcane cutters' workplaces would be an important strategy directed at this population of male rural workers.
A essência do cuidado à criança com asma
(Universidade Federal de Goiás, 2014-07-02) Siqueira, Karina Machado; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Teixeira, M. F.; Castral, Thaíla Corrêa; Salge, Ana Karina Marques; Andraus, L. M. S.
Among the chronic diseases that affect children's health, asthma deserves special mention because of its high prevalence and the impact it can have on a child's life. Given its complexity, the care of children with asthma should be shared between the family and a team of health professionals trained for this purpose. This study aimed to unveil facets of the essence of this care, according to the perceptions and experiences of children and their families. For value conscious experience of people, the phenomenology was chosen as theoretical and methodological referential. Through this approach, was possible to shed light to what is essential in the care of these children and advance in the elucidation of this phenomenon, from its intentional structure. The care was taken as the centerpiece of discussions and, accordingly, became appropriate appeal to think of Martin Heidegger, in order to enlarge the possibilities of understanding and discuss some issues that converge to the phenomenology of care. Participated in the survey five families of children with moderate or severe asthma, aged between seven and ten years, attending in a outpatient clinic specializing in childhood asthma, located in Goiânia-GO. Data collection occurred during home visits between September 2013 and January 2014. Initially were elaborated genograms and ecomaps representing families and, then, were made interviews with children and family, mentioned as participants in care. Descriptions expressed were analyzed according to the Method of Qualitative Analysis of Situated Phenomenon. The invariant structure of the phenomenon directed to three major themes: Being with a child with asthma; The family care to children with asthma; Be children with asthma: particularities and restrictions. Data analysis aggregated relevant aspects for the understanding of the essence of the care of children with asthma and were presented in the form of articles. The joint construction of genograms and ecomaps favored the approximation with families and facilitated the conduct of interviews according to the phenomenological method. The results enabled us to understand that the established relationships with the child, the members of the family unit, health services and religious institutions stood out as sources of support for care. The school was presented as a space of relevance, which found support, but also experienced situations of embarrassment and exclusion. Family members described their anxieties, fears and difficulties, especially during asthma attacks. Highlighted particularities and restrictions in the lives of children and in family environment, and described attitudes of protection. Emerged the difficulty of children in dealing with some fears, frustrations and constraints related to the disease and treatment, but also became clear their strengths and their families’ strengths to take care of more autonomous and effectively way. The study revealed that knowledge about the experiences of families provides important information for health professionals that work within the context of childhood asthma and may contribute to better understanding of the proposed interventions, promoting new strategies of attention.
Estratégias de atenção aos cuidadores informais de idosos: pesquisa participante baseada na comunidade
(Universidade Federal de Goiás, 2017-03-27) Borges, Cristiane José; Munari, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716; Munari, Denize Bouttelet; Stacciarini, Jeanne Marie Rodrigues; Medeiros, Marcelo; Santana, Rosimere Ferreira; Pagotto, Valéria
INTRODUCTION: The process of population aging is a worldwide phenomenon and, simultaneously, a new social role emerges - the informal caregiver-, seen as an essential component to promote elderly’s quality of life in some dependency situation at home. OBJECTIVE: To describe the construction and implementation of care and support strategies for elderlies’ informal caregivers through the Community Based Participatory Research. METHOD: A descriptive study guided by Community Based Participatory Research (CBPR) principles and carried out through the organization of a Community Advisory Committee (CAC), which involved academic and community participants. The study was attended by 384 people, nine community partners, 255 professionals working in family health strategies and 120 elderlies’ informal caregivers. The research was divided into the following phases: 1 - establishment of the community partnership; 2 - identification of problems related to elderly’s informal caregiver; 3 - prioritization of problems related to elderly’s informal caregiver; 4 - capacity survey of community strengths, dynamics and resources; 5 – arrangement of strategies, method, support and care interventions to elderly’s informal caregiver; 6 - implementation of strategies, method, support and care interventions to elderly’s informal caregiver; 7 - data analysis by CAC members; 8- dissemination of results obtained with CAC partnership; 9 - maintenance, CAC sustainability and partnerships evaluation. For the results’ analytical process, the content analysis proposed by Bardin was used for qualitative data and the descriptive statistical analysis was used for quantitative data. The Bioecological Theory of Human Development was adopted as a complementary basis for data analysis. RESULTS: Through the CAC constitution, there were identified, in a collective way, 17 problems faced in the elderly’s informal caregiver daily life. The use of the Severity, Urgency and Trend matrix allowed these problems prioritization for decision making. This process mobilized the construction of an action plan composed by five strategies: 1 - teaching of CAC members about the concepts recommended to define the caregiver role; 2 -raising the knowledge of Family Health Strategy professionals about the importance of including the informal caregiver as a care focus; 3 - performance of the 1st Multiprofessional Care Meeting for Elderly and Informal Caregiver; 4 - recording of the city’s informal caregivers of elderly people; 5 - qualification of the elderlies’ informal caregivers. CONCLUSION: The use of Community Based Participatory Research enabled the community partners’ empowerment, that mobilized themselves in support of elderlies’ informal caregivers, developing actions that included the mapping of the city’s informal caregivers of elderly people, mobilization and qualification of the Family Health Strategy professionals, and the organization of care spaces. In this process, it was verified that this research approach strengthens health democratization by promoting greater involvement and social protagonism of community partners, creating ideas and concrete actions for the establishment of care strategies for the elderlies’ informal caregivers.
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.

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