Mestrado em Enfermagem e Saúde (FEN)

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Efetividade do guaraná (Paullinia cupana) para manejo da fadiga em mulheres com câncer de mama em quimioterapia: um ensaio clínico, duplo cego, randomizado
(Universidade Federal de Goiás, 2017-03-16) Albarnaz, Marcela Dias; Mota, Dálete Delalibera de Correa de Faria; http://lattes.cnpq.br/1684517331855276; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Freitas Junior, Ruffo de; Malaquias, Suelen Gomes
Fatigue, a symptom of hard treatment due to its multi-dimensionality and multifactoriality, is frequently reported by women with breast cancer undergoing chemotherapy. Researches indicate that guaraná (Paullinia cupana) is a promising intervention for the control of the symptom, but the results still do not show themselves consistent. OBJECTIVE: Assess the effectiveness of 50 mg of guaraná (Paullinia cupana), received twice a day by mouth, for the treatment of fatigue in women with breast cancer under chemotherapy. METHOD: It consists of a randomized clinical trial, double-blind, phase II, placebo controlled. Fatigued women undergoing chemotherapy as the only therapy for the cancer control were randomized in two groups: guarana group (GG) and placebo group (PC). For both groups, an educative program has been conducted in order to uniform the information regarding fatigue. The patients were evaluated in three moments: baseline, 45 and 90 days after the first evaluation. Fatigue was evaluated through the Piper Fatigue Scale- Revised. The analysis of the effectiveness of the intervention and the response rate were adjusted according to age, education level, overweight, medical diagnosis, chemotherapy type, comorbidity, anxiety, depression, alterations on sleep patterns, pain and treatment. RESULTS: 42 women were distributed among the GG (n=21) and PG (n=21) groups. We observed homogeneity in regards to socio-demographic clinical profiles. The inner-group evaluation revealed significant reduction on fatigue scores in GG group, on both total score and behavioral, affective and sensory/cognitive dimensions. The same was not observed on the GP group. The intergroup evaluation revealed a significant statistic difference between the two groups for total scores and behavioral, affective and sensory/cognitive dimensions at the 90th day. A multivariate analyses revealed a reduction of the fatigue rate in 63% (RRA: 0,37; CI 95%: 0,16-0,82) in the GC group. The results of η² revealed a moderate effect on the global fatigue treatment (η² = 0,22), behavioral (η² = 0,13), affective (η² = 0,22) and sensory/cognitive dimensions (η² = 0,16). CONCLUSION: The guarana has shown itself effective in the treatment of fatigue in women with breast cancer undergoing chemotherapy, after 90 days of treatment. The positive effect of the intervention has been observed in both the global fatigue score and in all dimensions evaluated (behavioral, affective and sensory/cognitive).
Risco biológico para o circulante de sala operatória
(Universidade Federal de Goiás, 2009-07-07) ALMEIDA, André Nunes Gomes de; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920
Employees of nursing during their work activities in the Surgical Center (SC), are exposed to various occupational hazards, among them biological. The objectives of this study were: to characterize vulnerabilities points to accidents involving biological material for the transient of the operating room (OR), in the trans-operative period and preparation of the Operating Room; to identify the adoption of universal precaution measures, identifying the occurrence of accidents with biological material and to determine the profile of accidents with biological material among circulating OR. Transversal descriptive study conducted with employees of nursing staff engaged in the activity of OR in the SC of a public teaching hospital in the city of Goiânia - GO. Data collection was performed using two instruments: a check list and application of a questionnaire both evaluated and tested. Filling out the checklist was it the first time of data collection that was done by direct observation of the activities of transients in the trans-operative care and dismantling the operating room, including the delivery of the material in the purge of the Centre of Material and Sterilization. Subsequently, a questionnaire was subject to the same observation. We met all the ethical issues for the consideration provided for in resolution 196 of the National Health Council. Data were grouped in tables and figures and descriptive statistics were used for frequency measurements. The data on the perception of transients regarding the observed behaviors were targeted on groups by hierarchical method, cluster analysis. Of the 37 eligible professionals, 30 participated. The majority (93.4%) female, working time in SC, for more than six years (56.6%) and half has another employment relationship, 40.0% with weekly working hours equal or above 60 hours. It was found that 56.6% of circulating never participates in training on biological risk and 34.0% learned the service following colleagues. The vaccine for hepatitis B was referred by 80.0% of workers, 40.0% had anti-HBs. No transient used protection goggles and 53.3% did not use closed shoes while working. Were reported several risk behaviors for exposure to biological material, among which stands out the use of procedure gloves to collect the instruments after surgery, the use of auxiliary table for carrying items such as: instrumental, glass suction, chamber using sharps; collected manually suture needles used in surgery. Disposal of sharps in the OR was predominantly inadequate and no review of the field after surgery occurred in 86.7%. Accidents with biological material were reported by 40.0% of transients, predominantly from percutaneous exposure to blood and only half have been informed about. Behavior characterized in this study, as risk of exposure to biological material, were recognized by circulating OR as present in the daily work, it was possible to observe concordance between both events (high-frequency behavior and high alert as a gift) and disagreement ( high frequency of observation with low alert) with the predominance of agreement. For all behaviors considered as risk of exposure to biological material there was recognition that this occurs. Some behaviors of transient increase the risk to workers from other units of the hospital. The results indicate the need for organizational and administrative changes to the confrontation of the biological risk inherent in the work of the transient of the operating room. Highlighted the need to intensify educational measures regarding the promotion of a safe environment for workers to be frequently reminded that their work exposes them to risks, and risks can be minimized through adherence to standard precautions
Utilização das recomendações para profilaxia de transmissão vertical do HIV
(Universidade Federal de Goiás, 2013-04-05) Almeida, Bruna Lígia Ferreira; Salge, Ana Karina Marques; Guimarães, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; Guimarães, Janaína Valadares; Manrique, Edana Joana Claudio; Souza, Sandra Maria Brunini de; Souza, Márcia Maria de; Tavares, Suelene Brito do Nascimento
The feminization of the epidemic have many consequences, among them, the increasing number of HIV-infected children with mother to child transmission as the main route of infection. In 2010, the Ministry of Health created the recommended prophylaxis manual of mother to child HIV transmission and antiretroviral therapy in pregnant women and other behaviors related to prevention of mother to child HIV transmission. The objective of this study was to analyze if the recommendations of the Ministry of Health as control of mother to child HIV transmission are being taken by pregnant women and health professionals of a public maternity hospital in Goiânia. Research conducted between March and May 2012, divided into two stages: cross-sectional study, which consisted in the analysis of medical records of 323 HIV positive pregnant women seen at a public hospital in the State of Goiás between years 2006 to 2011, and second it is cross-sectional study involving 25 professionals working in maternity and obstetric center of this institution. Among the 323 records analyzed, 48.9% of pregnant women were included in the age group between 25 to 34 years old, 68.7% were single, 65.6% brown, 50.5% had study time between 4-7 years and 74.9% were unemployed. We checked the main risks related to mother to child HIV transmission in the 323 analyzed records. Among of the professionals surveyed, 76% have inadequate knowledge about HIV testing in pregnant women, 80% unaware the gestational age in what is realized elective caesarean, 66% do not know the dose to attack AZT and the elapsed time before child-birth, 84% do not know which method is indicated for lactation inhibition. The data observed in our study are alarming and show gaps in care for HIV positive pregnant women and newborns exposed, through information obtained that contradict this practice.
Competências de enfermeiros recém-graduados para gestão: desafios para a formação profissional
(Universidade Federal de Goiás, 2023-03-17) Almeida, Daniel Ribeiro de; Santos, Patrícia Tavares dos; http://lattes.cnpq.br/8052298165888796; Ribeiro, Luana Cássia Miranda; http://lattes.cnpq.br/1727326201446926; Ribeiro, Luana Cássia Miranda; Medeiros, Marcelo; Pascon, Daniela Miori
Históricamente, las enfermeras han asumido cargos de gestión en las unidades de salud, pues desde su origen, la enfermería, a través de las damas enfermeras de la época de Florence Nightingale, ha tenido la preocupación de asegurar la organización y administración de los servicios de salud. En consonancia con esto, la formación de enfermeros incorpora en su estructura curricular horas específicas para disciplinas relacionadas con la gestión, siendo una de las pocas graduaciones en el área de la salud con esta especificidad. Por lo tanto, existe la necesidad de una mayor inversión en la formación de enfermeras gestoras, respondiendo a las demandas del mercado laboral y evidenciando las lagunas existentes en el desarrollo de habilidades directivas desde la graduación hasta la práctica profesional. OBJETIVO: Describir las percepciones de las enfermeras en sus primeros cuatro años de trabajo sobre las competencias para el ejercicio de la gestión sanitaria. METODOLOGÍA: Estudio descriptivo-exploratorio con abordaje cualitativo, realizado con 14 enfermeros recién graduados de una universidad pública de Goiás. A coleta foi realizada nos meses de agosto e setembro de 2022 utilizando um roteiro semiestruturado composto por sete perguntas abertas para descrição da percepção desses enfermeiros sobre as competências para a gestão. El análisis se realizó mediante el método de análisis de contenido de Bardin y, posteriormente, mediante la clasificación jerárquica descendente, el análisis de similitud, el análisis fatorial de correlación y el muestreo de palabras mediante el software IRaMuTeQ. RESULTADOS: La mayoría de las enfermeras ocupaban puestos asistenciales, con más de dos años de formación y un tiempo de desempeño equivalente al de su formación. Enumeraron las competencias directivas adquiridas durante la graduación: comunicación, gestión de conflictos, liderazgo, trabajo en equipo, relaciones interpersonales, gestión de flujos asistenciales, gestión de recursos humanos, financieros y materiales, toma de decisiones, gestión del tiempo, formación continuada y asistencia, de acuerdo con las Directrices Curriculares Nacionales de Enfermería (DCN/ENF). Durante su desempeño profesional adquirieron las competencias de gestión de conflictos, toma de decisiones, delegación de funciones y negociación, que se sumaron a las adquiridas antes de acceder al mercado laboral. Estas competencias fueron adquiridas durante el curso de graduación, que tuvo como diferencial una estructura curricular con asignaturas específicamente centradas en cuestiones de gestión de enfermería, con una gran carga de trabajo práctico que, según ellas, desencadenó una mayor adquisición de estas competencias, la participación en actividades extracurriculares, además de que la estructura del curso fue percibida como un ejemplo en términos de formación de enfermeras gestoras. Los participantes sugirieron puntos de mejora en la matriz curricular como la inserción de nuevas materias obligatorias como seguridad del paciente, inserción de simulación realista como estrategia para el desarrollo de competencias actitudinales y aproximación con campos de pasantía en el sector privado. CONSIDERACIONES FINALES: Los participantes de este estudio relataron un conjunto de competencias de gestión desarrolladas durante la graduación que van más allá de las exigidas en la ENF-DCN y señalaron contribuciones para la mejora de las matrices curriculares de los cursos de pregrado en enfermería. Se espera que otros estudios puedan ser desarrollados en otros contextos, como instituciones de enseñanza privada.
Avaliação de fatores de risco para hipertensão arterial entre adolescentes de Goiânia – GO
(Universidade Federal de Goiás, 2017-05-05) Almeida, Mayara Maria Souza de; Souza, Ana Luíza Lima; http://lattes.cnpq.br/6578713509935374; Souza, Márcia Maria de; http://lattes.cnpq.br/6954087338926237; Souza, Márcia Maria de; Sousa, Ana Luiza Lima; Vitorino, Priscila Valverde de Oliveira; Caetano, Karlla Antonieta Amorim
Adolescents present behaviors and important changes in the body, in the way of thinking, acting and in the performance of social roles, and especially exposure to behavioral risk factors. The objective of this study was to evaluate the risk factors for hypertension among adolescents from Goiânia - Go. This was a cross-sectional study, data collection was performed between 2013-2014, with the participation of 1,586 adolescents from 36 schools (public and Private schools) of 108 classes in Goiânia-GO. All adolescents were interviewed about socio-demographic and behavioral characteristics such as tobacco use, alcohol and other cardiovascular risk factors and also had blood pressure measured and weight and height measured. Data records were made on a digital device (PDA). There was a high prevalence of hypertension among adolescents: 6.2% (95% CI: 4.6-8.2%) in girls and 14.0% (95% CI: 10.2 -18.8%) In the boys. The prevalence of hypertension was twice as high in boys compared to girls (p <0.001). Overweight was independently associated with hypertension in girls. Obesity was a risk factor for hypertension in both sexes. Tobacco use was not a factor associated with arterial hypertension; tobacco use among boys was 19.3% (95% CI: 14.9; 24.5) and girls 19.1% (95% CI: : 15.8; 22.8) both with similar results to the use. Alcohol use in the last 30 days was not a factor associated with arterial hypertension; however, statistically significant results were found for binge drinking among boys (5.0%; 95% CI: 3.3; , 5) and in girls 6.8% (95% CI: 4.9, 9.3) (p <0.277). The results of this investigation indicate the need to implement strategies for the prevention and control of hypertension and risk factors, especially in the school context, with actions to promote health and training of professionals in the areas of education and health.
Autoavaliação de saúde, capacidade funcional e perfil demográfico, socioeconômico e clínico entre residentes em Instituições de Longa Permanência para Idosos
(Universidade Federal de Goiás, 2014-04-25) Alves, Denise Pinheiro Marques; Pereira, Lílian Varanda; http://lattes.cnpq.br/6953643275046028; Pereira, Lílian Varanda; Pagoto, Valéria; Souza, Sandra Maria Brunini de
Elderly living in Long-Term Care Institutions for the Elderly (LTCI) live with chronic illnesses and pain, which start/intensify disabilities, hamper the maintenance of daily activities and generative negative perceived health conditions. The study objectives were to analyze the demographic, socioeconomic and health conditions profile of elderly living in LTCI; to estimate the prevalence of disability in basic activities of daily living (BADL) and negative self-assessed health and associated factors. Cross-sectional, analytic study, undertaken between May and August 2012, involving 159 elderly living in LTCI, in the house-home and comprehensive care modalities. The target population in this study included elderly without a severe cognitive deficit (scores ≥13 on the Folstein Mini-Mental State Examination, Folstein Mchugh (1975), who lived in the seven participating LTCI (n=246), three of which were of the house-home and four of the comprehensive care type. The outcome variables were functional disability (assessed through the Katz Index) and negative self-assessed health (bad/vary bad). Depression symptoms were assessed by means of the thirty-point Geriatric Depression Scale and pain intensity through the verbal descriptors scale. The prevalence rates were presented with the respective confidence interval (95%CI). For analysis, the Prevalence Ratio (PR) and the Poisson regression model were used, including the variables with p<0.10. Values of p<0.05 were considered significant. Most of the population was female (53.5%), with a mean age of 77.1±8.8 years, without a partner (77.2%), with children (64.2%), mean education 3.6±4.0 years; who received retirement benefits (86.0%) and lived at the institution for less than six years (61.8%). Almost 60.0% of the elderly reported that they did not receive visits. The estimated prevalence ratio of morbidities was 90.1%, with higher frequencies for arterial hypertension (52.8%), cataract (51.6%), suspected depression (44.2%) and musculoskeletal diseases (33.3%). Little more than 40% presented four or more diseases. The prevalence of disability for BADL was 35.2% (95%CI: 28.2-42.9), independently associated to living in comprehensive-care LTCI (PR=2.06:1.15-3.74), negative self-assessed health (PR=1.60:1.02-2.46), lying down due to pain in the last seven day (PR=2.54:1.60-4.07) and reporting strong pain/worst possible pain while resting (PR=1.90:1.13-3.21). Negative self-assessed health was observed in 14.5% (95%CI: 9.8-20.8) of the elderly (6.3% = bad and 8.2% = very bad). This variable was significantly associated with the comprehensive-care modality (PR=3.16:1.11-8.92), worst health comparison (PR=1.88:1.03-3.44), suspected depression (PR=6.10:1.44-25.76), lying down because of pain in the last seven days (PR=2.83:1.24-6.49), and mentioning strong pain/worst possible pain while resting (PR=2.72:1.19-6.49). The assessment of elderly from a functional and self-assessed health perspective can favor the multiprofesional approach and contribute to identify factors that predispose to the worsening of health. The need is highlighted to readapt the care practice at Long-Term Care Institutions for the Elderly.
Percepções de puérperas acerca da violência obstétrica
(Universidade Federal de Goiás, 2017-08-24) Alves, Vittória Braz de Oliveira; Reis, Mary Lopes; http://lattes.cnpq.br/7369378240710386; Medeiros, Marcelo; http://lattes.cnpq.br/3009722217245952; Guimarães, Janaina Valadares; Vieira, Flaviana
The obstetric violence is one of genre violence types, which has been prominent in Brazil and the world due to its consequences in reproductive women’s health. The mistreatment and disrespect on the pregnancy and puerperal cycle care assistance are directly related to cultural, biological and social issues that involve the women’s health care. The aim of this research was to analyze the meanings of obstetric violence by puerperal women. This was a qualitative approach of social strategic research. The data was collected by semi-structured interview with 14 puerperal women from two Health Districts of Goiânia, Goiás, Brazil. All the qualitative material from the interviews was analyzed through the Content analysis thematic mode. From this analysis emerged the main thematic category entitled “experience of obstetric violence in prenatal, childbirth and postpartum" that is formed by other two subcategories. In the first one “health care process in pre-natal, delivery and postpartum”, women reported their experiences and most of them were marked by violence on each care phase. The second one, entitled "the feelings of experience" portray the feelings of the participants in face of the assistance received, especially sadness, anger and hurt. Feelings of victory, support and strength were reported by a minority of women. The study contributed to an important reflection about obstetric care at each stage of the pregnancy-puerperal cycle, through the meanings attributed by the women participating in the study. Evident that the fragility of prenatal care has negative repercussions for the woman in childbirth and puerperium. It is important to invest in replanning and improvements in women's reproductive health care, especially at the time of prenatal care, since focusing on quality educational actions aimed at the empowerment of women in childbirth and puerperium will total difference.
Práticas assistenciais e ocorrências de eventos adversos: percepção dos enfermeiros
(Universidade Federal de Goiás, 2018-04-30) Amaral, Robson Tostes; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Paranaguá, Thatianny Tanferri de Brito; Barreto, Regiane Aparecida dos Santos Soares
Objective: To analyze nurses' perceptions regarding nursing care practices and their relationship with risks and occurrence of adverse events in hospitalized patients. Method: Cross-sectional, correlational study developed in medical clinic units, surgical and renal replacement therapy of a public hospital of state education, with a population of 45 nursing assistants. Data collection was from January to May 2017, by means of the instrument "Adverse Events Associated with Nursing Practices", a self-administered questionnaire, with Likert type scales, translated and validated into Brazilian Portuguese. Results: The total number of participants was equivalent to 91.1% of the nurses working in the clinics surveyed, being 75.6% female, with an average age of 33 years, 53.7% had two or more employment relationships, average weekly working time of 56.2 hours and 63.4%, in the last 12 months, participated in a course on patient safety. In the general perception of nurses, 24.4% indicated that the occurrence of adverse events associated to care practices never/rarely compromises patient safety. Regarding the existence of risks and occurrence of adverse events were pointed out failures in the preventive practices, associated with inadequate clinical surveillance/judgment, defense deficit, falls, pressure injuries, medication errors, and health care-related infections. Maintain patient vigilance indicated a reduction in risk and occurrence of pressure injuries (p = 0.040). Preventive practices in pressure injuries (p = 0.0012), prevention of falls (p = 0.043), hand hygiene (p = 0.028) and care with personal protective equipment and environmental hygiene (p = 0.034), reduced adverse events in the medication process. In the nurses' perception, the existence of risk (24.4%) and occurrence (4.9%) of medication errors were high. Failures in the medication administration process increased the risk and occurrence of adverse events for falls (p = 0.049), pressure lesions (p = 0.012) and health care-related infections (p = 0.004). Failures in medication monitoring increased the risk and occurrence of falls (p = 0.035) and health care-related infections (p = 0.014). In the multiple regression analysis, medication preparation failures increased the risk and occurrence of adverse events in all phases of the medication process (p = 0.006). Considerations: Strategies related to the permanent training of the professionals in patient safety with approaches in the systemic errors associated to the organizational support for the learning is a way to be followed by the leaderships to minimize / mitigate occurrences of adverse events related to the assistance practices and with that to develop a safety culture focused on improvements in care quality in health and nursing services.
Prevalência dos marcadores da infecção pelo vírus da hepatite B em candidatos a primodoadores de sangue em Jataí, sudoeste goiano
(Universidade Federal de Goiás, 2009-07-10) ANJOS, Giulena Rosa Leite Cardoso dos; TELES, Sheila Araújo; http://lattes.cnpq.br/4975298732179917
To estimate the prevalence and evaluate risk factors to hepatitis B virus infection among candidates to first-time blood donnors in Jataí, southwest region of Goiás, 984 individulas were interviewed, blood samples were collected and screened for HBV markers (HBsAg, anti-HBs and anti-HBc) by enzyme immunoassay (ELISA). Most subjects were male (55.6%), from Jataí city (74.4%), aged < 40 years (71.5%) and had secundary education (77.2%). Almost half of them reported family income over US$500.00. An overall HBV prevalence of 6.9% (95% CI: 5.4 to 8.7) was found: 68 (6.9%) were anti-HBc-positive, three (0.3%) HBsAg-positive, and 41 (4.2%) anti-HBs-positive. Being from Jataí city (OR: 2.3, 95% CI: 1.0 to 5.0), having a history of blood transfusion (OR: 2.4, 95% CI: 1.2 to 4.9), having a piercing/tatooing (OR: 2.0, 95% CI: 1.2 to 3.6), having a history of drug use (OR: 2.6; CI 95%: 1.2-5.5), having unsafe sex (OR: 2.0; CI 95%: 1.1-3.6), having a sexual partner with hepatitis (OR: 16.5, 95% CI: 3.1 to 86.4), history of STD (OR 2.9, CI 95%: 1.4-5.8), and prostitution (OR: 2.4, 95% CI: 1.02-5.4) were factors independently associated with HBV positivity. It was found that the clinical screening had a sensitivity of 69%, specificity of 60.8%, positive predictive value of 11.6% and negative predictive value of 96.4%, respectively. The findings of this study suggest a low prevalence of hepatitis B in the southwest of Goias. However, the stricter association of HBV infection to risk factors/behaviors highlights the need for intensification of prevention programs for hepatitis B and other STDs in our region.
Qualidade de vida de agentes de segurança prisional de uma capital brasileira
(Universidade Federal de Goiás, 2019-03-27) Araújo, Cristiane Soares da Costa; Matos, Marcos André de; http://lattes.cnpq.br/1492491906180226; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Martin, Dolores Rodriguez; Vitorino, Priscila Valverde de Oliveira
INTRODUCTION: Given their working circumstances prison officers (POs) are regarded a vulnerable group, which impairs the sustainability or achievement of satisfactory levels of health and overall quality of life (QOL). AIMS: To assess the QOL of POs of a Brazilian capital and compare in accordance with socio-demographic and working condition factors. METHODS: A cross-sectional descriptive study carried out with 269 officers from five prisons, from November 2017 to July 2018.To gather data we used a questionnaire with socio-demographic and working condition variables and WHOQOL-Bref (World Health Organization Quality of Life Bref). To analyze QOL domains, we calculated mean, median and standard deviation with confidence interval (CI95%). We used t-Student test to analyze the mean differences of QOL domains between each investigated stratification variable, with p< 0.05 values being considered significant. RESULTS: This is a male-dominated population (75.1%) made up of 30-year-olds or over (62.1%), college graduates (70.5%), married (54.6%) and childless individuals (55%). Most (83.3%) of the interviewed officers have been in the job less than 5 years doing shift work (75.8%). History of violence and harassment at work was reported in 19.3% and 16.5%, respectively. QOL perception was higher (73.2%; SD=17.7) whereas satisfaction towards health was negatively perceived (68.8; SD=20.4). Women presented lower scores in the physical (p=0.001), psychological (p=0.004), social relations (p=0.01) and environment (p=0.02) domains. In the physical domain, those with a work harassment history presented lower scores (p=0.02). Regarding the psychological domain, individuals under 30 (p=0.04) and unmarried (p=0.01) presented lower scores in comparison to the others. The social relations domain presented the worst perception by those with higher education (p=0.006), who had no health insurance (p=0.04) and had been assaulted (p=0.04) and harassed at work (p=0.01). Lastly, regarding the environment domain, the uninsured officers (p=0.000), under 5 years in the job (p=0.01) and with a history of reported harassment (p=0.01) presented the lowest scores. CONCLUSION: The officers presented a good overall perception of their QOL despite having reported dissatisfaction towards their health status as well as work liability, which highlights the need for public policies that consider the specificities of their lifestyle and work environment. Our results suggest changes be made to devise feasible health-oriented strategies for this work segment in association with occupational health nursing.
Estudo de coorte sobre o uso de medicamentos potencialmente inapropriados em idosos
(Universidade Federal de Goiás, 2020-02-21) Araújo, Natacha Christina de; Pagotto, Valéria; http://lattes.cnpq.br/9865313041988933; Pagotto, Valéria; Silva, Ana Elisa Bauer de Camargo; Modesto, Ana Carolina Figueiredo
INTRODUCTION: Population ageing is accompanied by an increase in chronic diseases and use of medicines. Although pharmacological therapy plays an important role in disease control, some drugs are classified as Potentially Inappropriate Medicines (PIM), creating new challenges for the elderly, their families andhealth services.OBJECTIVE: To analyze the evolution, incidence and mortality of elderly people using Potentially Inappropriate Medicines (PIM) in a decade-long cohort study. METHOD: Prospective cohort epidemiological study, with a ten-year follow-up period, carried out in Goiânia, with an initial sample (baseline) of 418 elderly people in 2008. A home interview was conducted, using a standardized questionnaire including socioeconomic, demographic, living conditions and healthvariables. Information was collected on the active ingredient, dosage, route and schedule of the drugs. PIM were classified according to theAmerican Geriatrics Society Beers Criteria. The analyses were performed withSTATA 15.0. To analyze the factors associated with the incidence of PIM usage, a generalized linear model was constructed, and presented as Adjusted Relative Risk (aRR). In order to analyze the evolution of PIM usage, a longitudinal analysis was performed using Generalized Estimating Equations models. Finally, the mortality rate was calculated, as well as the effect of refusals and 6%loss from follow-up, totaling 221 included in the year 2018. The mean age was 79.1 years (± 5.8); 67.4% were women; 21.2% rated their health as poor or very poor, 24.4% were hospitalized in the last year and 69.2% presented more than three diseases. In 2008, the mean number of drugs used was 3.3 (± 2.6); while in 2018 the mean was 8.0 (± 5.1). In 2008, the PIM most frequently consumed were in this order: nifedipine, glibenclamide and sodium diclofenac. In 2018, the mostfrequently consumed were: sodium diclofenac, amiodarone and scopolamine. The incidence of PIM use in the sample of the elderly cohort was 44.1 cases (95% CI: 35.2-54.7) per 1,000 person-years (56 incident cases/1,270 person-years). Multiple regression revealed that the incidence of PIM use was statistically associated with polypharmacy (aRR: 3.00; 95% CI: 1.31-6.88) and diabetes mellitus (aRR: 1.57; 95% CI: 1.03-2.39). In the longitudinal analysis, elderly people with a history of hospitalization (RTaj: 1.20; 95% CI: 1.01-1.40), with three or more morbidities (RTaj: 1.41; 95% CI: 1.14- 1.74), using polypharmacy aRR(RTaj: 1.81; 95% CI: 1.47-2.24) and diagnosed with diabetes mellitus (PIM on the survival of the elderly, using Cox proportional regression analysis, presented as Adjusted Hazard Ratio (aHR). The study was approved by HC/UFG ethics committee.RESULTS: From a total of 418 elderly followed up, 34.9% died, there were¨6% RTaj: 1.24; 95% CI: 1.05-1, 47) had a higher rate of PIM usage over the ten years. The overall mortality rate in the group that used PIM at the baseline was 46.3 deaths (70/1,513 person-years) and in the unexposed group it was 37.7 deaths (75/1,992 person-years). In the Cox regression analysis adjusted according to age, sex, economic class, polypharmacy and use of PIM, no statistical association was observed between survival of the elderly in the cohort and use of PIM in the adjusted analysis (aHR: 1.02; 95% CI: 0.69-1.51). CONCLUSION: This research indicated that the incidence of PIM usage in the elderly is high, and polypharmacy and Diabetes Mellitus are factors that increase both the incidence and the rate of use. Although PIM usage has not decreased, the survival of the elderly and the association of polypharmacy with mortality show that the use of medications in the elderly should be continuously monitored. The results are a warning to prescribers and health professionals regarding the rational use of medicines in the elderly population, in order to prevent adverse reactions and other health problems. Furthermore, they signal the need to review the type of drugs used and to monitor their use at all levels of health care and especially primary care.
O Serviço de Triagem do Hospital das Clínicas da Universidade Federal de Goiás- promotovendo o acolhimento e a reorganização institucional
(Universidade Federal de Goiás, 2004-12-17) AZEVEDO, Jane Mary Rosa; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225
As interfaces do reprocessamento de endoscópios pelo uso de glutaraldéido em serviços de endoscopia de Goiânia
(Universidade Federal de Goiás, 2008-04-24) BARBOSA, Jackeline Maciel; PIMENTA, Fabiana Cristina; http://lattes.cnpq.br/2230554075502158; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264
SUMMARY: This is a descriptive research carried out in twenty digestive endoscopy services at the municipality of Goiânia. We aimed at characterizing the endoscope reprocessing through the use of glutaraldeide in upper digestive endoscopy services. The sample was constituted by endoscopes used for upper digestive endoscopy and professionals performing these endoscope reprocessing. We observed ethical legal aspects of human research. Data was collected through direct observation of the physical structure of the place used for endoscope reprocessing and the individuals performing such reprocessing and recorded in a check list. In each service we obtained samples of three endoscopes, able to be chosen the first, the second, and the last endoscope used in that period. Samples were collected in the border, biopsy channel, and aspiration channel of each endoscope right after the use and at the end of reprocessing. Samples were processed in the Laboratório de Bacteriologia Médica of the Instituto de Patologia Tropical e Saúde Pública of the Universidade Federal de Goiás. Microorganisms were identified concerning the form through Gram coloring technique. For isolated bacteria we performed the susceptibility profile. We carried out twenty observations regarding physical structure, one in each service. Sixty endoscope reprocessing were observed, three in each service. The outcomes showed that reprocessing is carried out in the same screening room without proper flow of service. All reprocessing stages showed failure. Errors were observed during the cleansing stage due to the use of enzyme detergent and brushing only the biopsy tubes. Disinfection was identified in all reprocessing, however it was not observed at 2 % concentration of germicide, there was no aspiration of the product in the internal channels and total immersion of the endoscopes, and exposure time to glutaraldeide was lower than the recommended one. Rinsing was most of the time with unfiltered water. The internal channels drying was improper due to the nonuse of compressed air. Adequate conditions to endoscope storage were identified. Microbial range of contaminated endoscopes was low, between 101 a 104 ufc/mL. Performing the precleansing stage, the use of enzyme detergent, cleansing of internal endoscope tubes, and the filling of these tubes with glutaraldeide were the significant variables, < 0.005 for the efficiency of endoscope reprocessing. These stages were crucial to reduce microbial burden. Chemical disinfection through the use of glutaraldeide was efficient in the endoscope reprocessing in eight services which is evidenced through the elimination of initial microbial range, however failures in the reprocessing of those were identified. We isolated from decontaminated endoscope: S. aureus, Staphylococcus coagulase negative, Enterobacter agglomerans, Enterobacter sp., E. coli. These microorganisms were susceptible to antimicrobials tested, except for azitromycin-resistant Gram-negative bacteria. This study shows that despite the low microbial range of contaminated endoscopes, disinfection has not been achieved in all services due to reprocessing failures, mainly in the cleaning stage. We consider adherence to endoscopes reprocessing protocols eliminates the major failures identified in the reprocessing
Tendência temporal da taxa de hospitalização por tromboembolismo venoso em idosos brasileiros de 2010-2020
(Universidade Federal de Goiás, 2021-12-15) Barp, Milara; Malaquias, Suelen Gomes; http://lattes.cnpq.br/7700996339438497; Pagotto, Valéria; http://lattes.cnpq.br/9865313041988933; Pagotto, Valéria; Cordeiro, Jacqueline Andréia Bernardes Leão; Nunes, Daniella Pires
INTRODUCTION: Venous thromboembolism (VTE) is a clinical condition that includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PE). Approximately 60% of VTE cases worldwide affect people aged 65 years or older. In addition to the higher incidence of the disease, the older people have more frequent hospitalizations and mortality from this disease. Thus, in the older people, the disease is more challenging to health systems. Changes in the treatment of VTE in recent years, require analysis of its distribution to assess the impact on health services, considering that studies on the distribution and trend of hospitalizations in the older people are limited in Brazil. OBJECTIVE: To analyze the temporal trend of hospitalizations for venous thromboembolism (VTE) in the older people Brazilians from 2010 to 2020. METHODOLOGY: This is an ecological time series study, using secondary information from the Hospital Information System (SIH) of the Unified Health System (SUS). Hospital admission records of elderly people aged 60 years or over available at the SIH/SUS for the period 2010-2020, with a main diagnosis of VTE, were included. Prais-Winsten regression was used for trend analysis. RESULTS: There is a trend towards a decline in hospitalizations for VTE, with an annual percentage change of -40.71 (95%CI-50.46;-29.04). The decline in hospitalizations for VTE was seen in all regions, with the exception of the Northeast region, which showed a stationary trend. Reduction in hospitalizations for DVT, with an annual percentage change of -43.14 (95%CI -51.36; -33.54). There was a downward trend in hospitalizations for DVT in all regions, with the exception of the Northeast region. On the other hand, the trend of hospitalizations for PTE was ascending, with an annual percentage change of 4.33 (95%CI 1.26; 7.48). The upward trend in the country for hospitalizations for PTE was also verified in the Northeast region, however, it was stationary in the other regions. CONCLUSION : The results show a declining trend in hospitalization rates for DVT and VTE, but there was an upward trend for PTE. The study also points out differences in rates and trends between Brazilian regions.
RESÍDUOS BIOLÓGICOS NOS INSTITUTOS DE MEDICINA LEGAL DE GOIÁS: IMPLICAÇÕES PARA OS TRABALHADORES
(Universidade Federal de Goiás, 2006-03-03) BARROS, Izildinha Pedreira; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920
Institutes of Forensic Medicine (IFM) perform exams and forensic studies implying in the generation of biological, chemical, radioactive, and common wastes. Thus, the workers can be exposed to biohazardous materials, mainly, due to the non-adherence to recommended practices in their management. Aiming at decreasing such risks, the Health Ministry has established rules defining guidelines to be undertaken by all institutions which generate Health Hazardous Wastes (HHW), including Institutes of Forensic Medicine. This paper had the following goals: diagnosing the management of biological waste generated by IFMs in Goiás as well as their implications to the workers; identifying them, in accordance with different stages as established in the current national legislation; verifying the situation of occupational biohazards for the workers of such institutions in Goiás. Data was collected through questionnaires, check lists, and interviews. Questionnaires were applied to 10 directors, and 81 workers were interviewed. The observation outcomes were recorded in a check list. Despite the fact that such facilities generate wastes similarly to any other health care facility, the first ones are non-segregated, non-conditioned and disposed in accordance with current legal rules. Sharp instruments management is shown as a main hazard to workers, which can be evidenced by the records of percutaneous injuries, while discarding. However, there is some awareness among workers concerning biohazards involved in the activities they perform. There is low adherence to protective measures. Most workers do not use protective individual barriers as recommended, and do not show a complete vaccination plan against tetanus and Hepatites B virus. The outcomes show the lack of a policy towards biohazards, and the need of continuing education concerning biosafety measures in such facilities.
Colonização nasal de cirurgiões-dentistas em atividade docente por bactérias gram-negativas: interfaces com as medidas de prevenção e controle
(Universidade Federal de Goiás, 2016-03-28) Batista, Késia Cristina de Oliveira; Leão-Vasconcelos, Lara Stefânia Netto de Oliveira; http://lattes.cnpq.br/5423949965995995; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; Paiva, Enilza Maria Mendonça de; Carneiro, Lilian Carla; Prado, Marinésia Aparecida do; Lima, Ana Beatriz Mori
This was an epidemiological, cross-sectional analytical study, performed in a Higher Education Institution (HEI) of Goiás/Brazil, with data collection from July to October 2014. Data were collected through a structured questionnaire and biological material collection (nasal swab). The level of nasal cavity colonization of DS teachers by Enterobacteriaceae was considered high (22.0%), with 14.6% of professionals being colonized by multiresistant microorganisms. These results were associated with inadequate personal habits and provide evidence for broadening the discussion of this issue among DS and directing strategies for controlling the biological risk for dentistry workers.
Qualidade de vida e letramento funcional em saúde de portadores de hipertensão arterial residentes na zona rural
(Universidade Federal de Goiás, 2016-02-23) Bernardes, Carla de Paula; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Vila, Vanessa da Silva Carvalho; Oliveira, Lizete Malagoni de Almeida Cavalcante; Barbosa, Maria Alves; Cordeiro, Jacqueline Andréia Bernardes Leão
Chronic diseases as hypertension can affect people's health-related quality of life (HRQoL) mainly if associated to inadequate health literacy. Living in a rural area difficult accessing health services. This study aimed to evaluate HRQoL and health literacy of people living with hypertension in rural areas. The descriptive study included 114 hypertensive individuals living in rural areas, who are assisted by Brazil's Family Health Strategy. It was used instruments as SF-36v2, MINICHALBrazil and the Brief Test of Functional Health Literacy in Adults (B-TOFHLA). Data were analyzed descriptively using Anova, Mann-Whitney, Kruskal-Wallis and T-Tests. The individuals were mainly female, mean age 59 years, 8 years or less of schooling. Body Mass Index indicated altered weight (≥ 25 Kg/cm2 ), even they referring daily habits changes after medical diagnose of hypertension. The lower SF-36 scales scores were “general health perceptions” (46,58) and “physical functioning” (51,10); the highest were “social functioning” (76,86) e “mental health” (72,49). MINICHAL domains scores were “mental status” (5,9) and “somatic manifestations” (3,3). There was correlation between SF-36 and MINICHAL scores. The health literacy test pointed to a inadequate health literacy for most of hypertensive individuals. Differences between man and woman were shown in most of SF-36 scales scores. Health literacy level was inadequate between the older and those with less years of schooling. It was concluded that people living with hypertension in rural areas have altered quality of life and limited health literacy. They should have easier access to health programs to receive Family Health Strategy attention, considering their literacy needs. Results suggest health professional strategy changes for hypertensive individuals living in rural areas, to effective health related care, self care and better quality of life
Crenças da equipe multiprofissional relacionadas à segurança do trabalhador na atenção primária à saúde
(Universidade Federal de Goiás, 2015-06-16) Bernardes, Marielle Sousa Vilela; Barreto, Regiane Aparecida dos Santos Soares; http://lattes.cnpq.br/4032250808062336; Prado, Marinésia Aparecida do; http://lattes.cnpq.br/1151975582155991; Prado, Marinésia Aparecida do; Souza, Adenícia Custódia Silva e; Siqueira, Karina Machado; Hayashida, Miyeko; Brasil , Virginia Visconde
Primary health care workers are exposed to many occupational hazards related to its activities, among them those biological. Understanding and identifying these risks by workers promote behavior change and can make them adhere to safety measures. GOAL: To identify multidisciplinary team workers beliefs of primary health care related to worker safety, the biological risk at workplace. METHODOLOGY: Descriptive study with qualitative approach, performed in seven units of primary health care in the city of Goiânia-GO, in 2014. The study included 43 workers, seven nurses, seven dentists, four doctors, five technicians / assistants in oral health, eight nursing technicians, six administrative assistants and six auxiliary hygiene and cleanliness. We used the technique of critical incident data collection, with semi-structured interviews with two parts: the first looked at data from the subjects characterization and, second, information on the subject. It was conducted content analysis, according to Bardin, discussed based on Health Belief Model of Rosenstock. RESULTS: As to gender, 88.4% were female, aged between 24 and 66 years, mean 46 years. According to vocational training, 16 (37%) were post-graduates; 12 (28%) completed high school; seven (16%) incomplete higher graduation course; four (9%) complete graduation course, and four (9%) primary school. The training ranged from four to 34 years. It was identified that the workers still lack clarity about their vulnerability to biological hazards at workplace. Understanding these workers, on such risks leads to other health facilities as hospitals and emergency services. However, they realized the beliefs related to preventive measures as benefits. This severity was unveiled from previous experiences of workers in working accidents. CONCLUSION: The beliefs of workers in primary health care, related to worker safety at the workplace, expressed basic concepts and are often inconsistent on the subject. These difficulties show health policies of poor investment in human resources on safety perspective. The workers were not able to enter the labor everyday life, a culture of appreciation of biological risks and adherence to preventive measures recommended by the Brazilian guidelines. The evidences in this study make us to rethink the interfaces involved in the work process and biological hazards in low and medium level complexity. Therefore, we propose a continuing education program in health, which instigates the technical improvement and security of organizational culture at the workplace in all health care levels by emphasizing the worker's beliefs.
Limpeza de feridas: caracterização e validação de protótipo para aquecimento de soro fisiológico e normatização de seu uso em unidades ambulatoriais
(Universidade Federal de Goiás, 2015-11-09) Bezerra, Jaqueline Evangelista da Costa; Nerys, José Wilson Lima; http://lattes.cnpq.br/6816730643886734; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Nerys, José Wilson Lima; Vieira, Marcus Fraga; Pereira, Lílian Varanda
Although the literature evidence the importance of using heated solution to clean injuries while doing a curative, there is not a safe and accessible procedure to heat solutions for this purpose yet. Objective: Test the efficiency of equipment produced to heat saline solution applied to treat injuries at ambulatory of curative; identify the time to cold the heated saline solution when exposed to the environmental temperature. Objective: Test the efficiency of equipment produced to heat saline solution applied to treat injuries at ambulatory of curative; identify the time to cold the heated saline solution when exposed to the environmental temperature. Method: Experimental study of technological innovation accomplished in three stages: the prototype development; efficiency test of heating saline solution flacons; instruction of the using time of the heated solutions. Result: It was developed three prototypes: one of heating by means of Peltier cells, other one of heating by resistance and another one by electromagnetic irradiation, with different results regarding the efficiency.The time of cooling varied from 3 to 35 minutes, depending on the inicial heating,the size of the flacon and the type of wrapper Conclusion: The prototype that best complied with the purpose of safe heating of the solutions was the adapted microwave by reverse engineering, from parameters of standardization created at this research. The prototype was efficient to heat flacons except the 100-ml -tough wrapper flacon which did not reach the expected temperature, however it does not derail its use at wounds treatment. The heated solutions presented time of use differed in relation to the volume of the flacons. At clinical practice can be recommended the use of the flacons of 100 ml to 250 ml per 10 minutes ( except the 100- ml- tough flacon, which is 3 minutes) and of 20 minutes for larger flacons.
Desempenho dos indicadores de qualidade da assistência na fase aguda do infarto do miocárdio
(Universidade Federal de Goiás, 2015-03-23) Boaventura, Rafaela Peres; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Mussi, Fernanda Carneiro; Bezerra, Ana Lúcia Queiroz; Mery, Max Weyler; Oliveira, Lizete Malagoni de A. C.
This study aimed to analyze the pre-hospital course of patients undergoing percutaneous myocardial reperfusion in acute myocardial infarction and evaluate the performance of health care quality indicators of myocardial infarction in these patients. This is a retrospective cohort study with convenience sample. It was analyzed 39 cases of myocardial infarction with ST segment elevation, with Delta T up to 12 hours without previous administration of fibrinolytic agents, admitted for treatment at the General Hospital of Palmas / TO in 2013. Data were collected in the pre-hospital phase in records and interview and in the in-hospital phase through secondary data. For statistical analysis we used the Shapiro-Wilk test, Student's t test and ANOVA with 5% significance level. Most were male (76.9%), with a stable partner (74.4%), with up to nine years of education (64.1%) and at least three cardiovascular risk factors (79.5%). In the pre-hospital delta T phase was high (06h34min ± 03:14) and 10.2% achieved the recommended metric. The delta T was higher among patients that did not previously recognized symptoms of AMI (mean 07h09min ± 03h12min) and lower among those who were treated during the day (mean 03h 25min ± 05h35min). In-hospital phase, 56% were admitted during the day. In 30.8% of cases the Killip Kimball was > I. Among the other infarcted walls prevailed the bottom wall. Five patients (12.8%) died. Time door-ECG and needle holder did not follow international recommendations for all variables. The early recognition of symptoms and time of care are interfering for prehospital delay. There was no statistical correlation-balloon time and door-ECG door to the profile of patients with clinical variables in the hospitalization phase. The metric assessment of infarct treatment quality indicators in the acute phase was unsatisfactory throughout the study period.

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