Mestrado em Enfermagem e Saúde (FEN)

URI Permanente para esta coleção


Submissões Recentes

Agora exibindo 1 - 20 de 219
  • Item
    Conchas mamárias e educação em saúde no pré-natal com demonstração clínica para a prevenção da dor e do trauma mamilar em lactantes: estudo quase-experimental
    (Universidade Federal de Goiás, 2021-03-04) Cecilio, Jessica Oliveira; Guimarães, Janaina Valadares;; Vieira, Flaviana Vely Mendonça;; Vieira, Flaviana Vely Mendonça; Aredes, Natalia Del’ Angelo; Evangelista, Danielle Rosa
    INTRODUCTION: Although the benefits of breastfeeding are well documented in the scientific literature, many mothers still discontinue it earlier than recommended, especially due to the occurrence of nipple pain and trauma. There is a gap in clinical studies that compare health education with clinical demonstration, and the use of some ointment or device during prenatal care, to prevent nipple soreness. OBJECTIVE: To analyze the effectiveness of breast shells for the prevention of nipple pain and trauma in lactating women. METHODOLOGY: Quasi-experimental, with 62 pregnant women undergoing prenatal care in Goiânia-GO. The women were divided into a Control Group (n = 33), which received health education with clinical demonstration, and an Experimental Group (n = 29), which received the same education protocol, plus a pair of breast shells for use during prenatal and continued in the postpartum period. The study occurred in three meetings: first meeting was a section of health education during prenatal consultations; the second was a phone call to reinforce the orientation, and the third, was a visit in the first 14 days of postpartum to evaluate the occurrence of nipple pain and trauma. RESULTS: There was nipple trauma (50.0%) and nipple pain (68.0%). Regarding sociodemographic variables, primiparity was associated with nipple pain (p = 0.036), while lower education level was a protective factor for nipple trauma (p = 0.001). In breastfeeding technique observed by the breastfeeding assessment form, the parameter for "unfavorable breast condition" was associated with pain (p <0.001) and nipple trauma (p = 0.006). Furthermore, the presence of pathological breast engorgement was associated with nipple pain (p = 0.019) and started on the third day for the CG and was postponed until the fifth day for the EG, with a significant difference between the groups (p = 0.001). Health education has contributed significantly to the adoption of breast and nipple care and increased the frequency of favorable breastfeeding patterns. The women in the study were satisfied with the use of the breast shell. CONCLUSION: The educational intervention in prenatal care combined with the use of the breast shell was not effective in preventing nipple pain or trauma, although it has delayed the onset of breast engorgement by up to five days.
  • Item
    Análise da acurácia do conjunto de indicadores clínicos do diagnóstico de enfermagem controle ineficaz da saúde em pessoas com hipertensão arterial
    (Universidade Federal de Goiás, 2021-03-04) Silva, Ricardo Costa da; Silva, Viviane Martins da;; Cavalcante, Agueda Maria Ruiz Zimmer;; Cavalcante, Agueda Maria Ruiz Zimmer; Jensen, Rodrigo; Santos, Vinicius Batista
    The advanced nursing process early identifies the behavior of clinical practice phenomena, with self-care practices carried out by people with chronic heart diseases being one of the care pillars, especially for Arterial Hypertension (AH). To analyze the accuracy of the set of clinical indicators (CI) of the nursing diagnosis (DE) Ineffective Health Management (IHM) in people with AH undergoing outpatient treatment. In the first stage, a systematic review with meta-analysis was carried out to identify the clinical - population validity of the DE CIS. The PRISMA and STARD protocols were used to retrieve studies from databases MEDLINE via PubMed, Web of Science, SciELO, CINAHL, SCOPUS and EMBASE. For quality analysis, the modified QUADAS-2 protocol was applied. Statistical analysis was performed using software R to calculate sensitivity, specificity and Odds Ratio Diagnostic (ORD) measures with 95% confidence intervals. Heterogeneity was verified by calculating Higgins' I2 and Cochran's Q, using measures of fixed and random effect according to the obtained value. In the second stage, a clinical study of diagnostic accuracy was conducted at the Hypertension League of HC/UFG with a probabilistic sampling of 120 people by telephone consultation between September and November 2020. Cross mapping was used between the items of the Hipertension Self-Care Scale Brazilian version and the CI of the DE IHM for the definition of conceptual and operational definitions, in addition to clinical and sociodemographic instruments developed by the author. The Rasch model was used to analyze the unidimensionality of the clinical construct and the accuracy measures of the model based on the measures of efficiency, sensitivity, specificity and area under the Operator-Receiver Curve (ORC). Stage I: 11 studies were included. The four CI analyses showed ORD statistically higher than the unit value, with emphasizing on “failure to include treatment regimen in daily life” (ORD = 45). Stage II: median of 60 years of age, more frequent female (70%), brown color (55%), married (60%) and retired (36%). The main source of purchase of medicines was the popular pharmacy (66%) and 83% reported some comorbidity, with dyslipidemia being more frequent (38%). The median time of diagnosis of AH was ten years. The CI “failure to include treatment regimen in daily life” was the most frequent in the sample (70%), being more sensitive. The CI “failure to act to reduce risk factors” presented better levels of specificity. There was a frequency of 45 subjects supposedly identified with CIS in the sample (37,5; IC95%: 29,0 – 46,8). The most sensitive CI results from the incongruity of the lifestyle habits necessary for adequate control of AH. The most specific CI is the result of the initial phase of the chronic condition, being present in situations of greater severity of ND. Sociodemographic and clinical variables were similar to other clinical contexts. Nurses can use the summary measures of diagnostic accuracy obtained for early and valid identification of behaviors that predispose to the occurrence of DE IHM.
  • Item
    Hepatite A em população imigrante e refugiada residente na região do centro goiano, Goiás: conhecer para intervir
    (Universidade Federal de Goiás, 2021-03-08) Silva, Grazielle Rosa da Costa e; Teles, Sheila Araujo;; Teles, Sheila Araujo; Caetano, Karlla Antonieta Amorim; Carneiro, Megmar Aparecida dos Santos
    Brazil has become an important destination country for immigrants and refugees. This migrant population represents a group at potential risk group for the acquisition and spread of enteral diseases such as infection with the Hepatitis A virus (HAV), as a consequence of the migratory process. The aim of this study was to investigate the epidemiological profile of Hepatitis A in foreign immigrants and refugees living in the region of Centro Goiano, Goiás. This is a crosssectional, analytical study, carried out from July 2019 to January 2020 in the cities of Goiânia, Aparecida de Goiânia, Senador Canedo and Anápolis, Goiás, Brazil. For this, 383 participants identified themselves as immigrants or refugees. All were interviewed and tested for detection of total anti-HAV antibody (IgM and IgG), as positive in participants under five years of age were retested for anti-HAV IgM and previous history of vaccination for Hepatitis A was investigated. From the total of participants, most were from Haiti (50.1%) and Venezuela (39.4%), male (56.1%), aged 20 years or over (79.9%), self-declared color black (63.0%), single (51.1%), evangelical religion (73.3%), education equal to or greater than 13 years of study (36.9%) and monthly income greater than a minimum wage (61.5%). Of the total owners, 68.7% were immigrants and 30% refugees. The language was the greatest difficulty (63.0%) found in Brazil, although a significant portion already speak (71.4%) and write (53.2%) the Portuguese language. Church related associations (32.9%) were the main support they received. The prevalence of total anti-HAV was estimated of 87.3% (95% CI :83.4-90.4), with 79.1% in South American countries and 93.5% in Central American countries. Regarding vaccination as a preventive measure, only 2.9% of them were a historical source of vaccination against Hepatitis A, and their ages ranged from 2 to 47 years, the majority being female (6/11) and coming from Venezuela (7/11). The total of 21 children were eligible for vaccination against HAV when they arrived in Brazil, but only 7 (33.3%) were immunized. The results of this study confirm the importance for health managers to knowing the state of the migrant population for the development of public policies at national and regional levels that qualify t
  • Item
    Fatores associados à qualidade de vida de idosos com dor crônica atendidos em ambulatórios de especialidades
    (Universidade Federal de Goiás, 2020-04-20) Paz, Maressa Gonçalves da; Barbosa, Maria Alves;; Pereira, Lilian Varanda;; Barbosa, Maria Alves; Vitorino, Priscila Valverde de Oliveira; Pagotto, Valéria
    INTRODUCTION: The quality of life (QOL) of the elderly can be affected by chronic pain. Among the domains of multidimensional instruments that evaluate this construct, the most frequently harmed are the physical and the psychological. However, there is a lack of evidence about the factors associated with domains and facets of QOL in elderly people with conical pain. Research on this topic can assist health professionals and in making decisions that contribute to the QOL of this population. OBJECTIVES: To analyze the quality of life and the associated factors by domains of the World Health Organization Quality of Life - Bref and facets of the World Health Organization Quality of Life - Old in elderly people with chronic pain treated in specialized clinics. METHODOLOGY: Cross-sectional study, conducted with a sample of 239 selected elderly. Participants assessed pain intensity using the Brief Pain Inventory (BPI) and QOL by WHOQOL-Bref and WHOQOL-Old. Sociodemographic (gender, age, education, income, marital status, religion) and clinical variables (time spent with pain, intensity, places of pain and morbidities) were investigated as potential factors associated with the domains / facets. Statistical analysis was performed using simple and multiple linear regression. Values of p <0.05 were considered. RESULTS: The total QOL score by WHOQOL-Old was (66.5 ± 12.0). The Physical (51.3 ± 17.2) and Environmental (57.6 ± 14.4) domains and the Autonomy (61.8 ± 17.8) and Social Participation (63.5 ± 18.4) facets by WHOQOL -Bref and WHOQOL-Old, respectively, had the lowest mean scores. Depression was associated with Physical (β = -8.12), Psychological (β = -10.84) and Environment (β = -6.52) domains and Autonomy (β = -5.99), Past Activities Present and Future (β = -6.94), Social Participation (β = 11.53), Intimacy (β = -5.99), and total QOL score (β = -6.03). Diabetes mellitus was associated with the Physical domain (β = -5.14) and the Social Participation facet (β = -8.15). Pain intensity was associated with the Physical (β = -2.69), Psychological (β = -1.14), Social Relations (β = -1.42) domains and the Sensory Skills facets (β = - 1.70), Social Participation (β = -1.43) and total QOL (β = -0.75). Another factor associated with the Psychological domain (β = -5.12) and with the Social Participation facet (β = -5.94) was pain located in the lower limbs; chest pain was associated with the Autonomy facet (β = -6.12); localized pain in the head with the Intimacy facet (β = -3.19) and with the total QOL score (β = -4.89). Education was associated with the Social Relations domain (β = -0.80) and with the Social Participation facet (β = -0.64). Female gender and family income were associated with the Environment domain (β = 4.71; β = 1.39) respectively. Age and time of living with pain were associated with the Sensory Skills facet (β = -0.52; β = -14.53; β = -17.86; β = -15.53) and Systemic Arterial Hypertension with the Death and Die facet (β = -8.40). CONCLUSION: Intensity and location of chronic pain and symptoms of depression were the factors that were associated with a greater number of domains and facets of the WHOQOL, increasing the chances of elderly people with chronic pain presenting impairment of quality of life. The results of this study can assist in decision-making for the provision of qualified and individualized assistance to elderly people with chronic pain in outpatient care
  • Item
    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;; Pagotto, Valéria;; 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.
  • Item
    Incidentes em sessões de hemodiálise à beira leito em unidades de terapia intensiva
    (Universidade Federal de Goiás, 2019-03-29) Costa, Natália Nunes; Barreto, Regiane Aparecida dos Santos Soares;; Barreto, Regiane Aparecida dos Santos Soares; Freitas, Nara Rúbia de; Cavalcante, Agueda Maria Ruiz Zimmer
    OBJECTIVE: Analyzing the incidents that occurred during the hemodialysis sessions at bedside in the Intensive Care Unit. INTODUCTION: the Intensive Care Unit are highly complex assistance environments that are conductive to the occurrence of incidents. A complex treatment realized in the hemodialysis service at bedside, indicated by the nephrologist to the severer patient aiming, to keep it metabolically stable. The hemodialysis at bedside is adapted to the environment of Intensive Care Unit, although the legislation is still incipient. Hemodialysis sessions can bring on incidental that compromise patient safety. These circumstances have potential to cause damage such as injuries, disabilities and even death. Therefore, it is necessary to understand the etiology, the contributing factors and the possible consequences of such incidents, with subsidies for strategies to promote patient safety, involving professionals that perform hemodialysis assistance, in the search for a continuous improvement culture. METODOLOGY: Cross-sectional, analytical and retrospective study, developed in 10 (ten) Intensive Care Units of Goiânia-GO, during hemodialysis sessions performed by a specialized outsourced clinic. The data collection was performed through the analysis of incidents reports, performed by the nursing team in the hemodialysis prescription at the bedside, from march to april of 2018, using a structured instrument elaborated for this purpose. Descriptive analysis was performed for categorical data, presented in absolute (n) and relative (%) frequencies and for continuous data in mean and standard deviation of the mean. To test the homogeneity of the groups in relation to the proportions, it was used the Two-Tale Fisher's Exact Test. The research has ethical approval, under CAEE nº61669016.2.0000.5078. RESULTS: During the data collection period, 873 hemodialysis sessions were performed and 563 incidents were recorded. Incidents were prevalent in male patients over 60 years old, who had diabetes mellitus and underwent hemodialysis in the SLED modality, using a central catheter for hemodialysis and without heparin. Among the reported incidents, 46.00% (259) were considered to be inherent to the treatment, with hypotension predominating, 28.06% (158) incidents with health technology, with a predominant report of leakage of the water treatment system (portable osmosis), 20.43% (115) care incidents, with emphasis on incompatibility of access to the prescribed flow, and 0.35% (02) incidents involving health products. In general, these incidents were identified by the nursing technician, who attended the hemodialysis session, prior to the patient's injury, although they requested vigilance, delayed the start of the session and did not obtain support from the unit's multiprofessional team at the time of the incident. In 56.12% (132) of the intimate circumstances, the professional worked for more than 12 uninterrupted hours. CONCLUSION: The most recorded were avoidable incidents that generated delay to start treatment and required patient monitoring, despite the non-predominance of damages. Visionary actions are necessary to mitigate incidents and promote safe care during bedside hemodialysis sessions.
  • Item
    A lanolina anidra combinada à educação em saúde no pré-natal para prevenção da dor e trauma mamilar em lactantes: ensaio clínico randomizado
    (Universidade Federal de Goiás, 2019-12-06) Oliveira, Flávia Silva e; Guimarães, Janaína Valadares;; Vieira, Flaviana Vely Mendonça;; Viera, Flaviana Vely Mendonça; Guimarães, Janaína Valadares; Aredes, Natalia Del' Angelo; Almeida, Nilza Alves Marques de; Siqueira, Karina Machado
    INTRODUCTION: Nipple pain and trauma are multifactorial breast complications with higher incidence at the beginning of breastfeeding. They are considered predictive factors for early weaning. There is still not enough evidence in the literature to recommend a method as the best in preventing nipple pain and trauma. OBJECTIVE: To compare the effect of anhydrous lanolin combined with health education on prevention of nipple pain and trauma with health education on breastfeeding in lactating women. METHODOLOGY: A randomized, controlled, open clinical trial with 82 women undergoing prenatal care in the public health care system, with a gestational age of 35 weeks or more. Data collection took place between May 2018 and February 2019. Women were randomized using computer-generated numbers (1: 1) in control group (41) and experimental group (41). In the experimental group, the women received the anhydrous lanolin ointment for immediate use, health education through an illustrated serial album and didactic breast demonstration; in the control group, the women were oriented according to the breastfeeding health education protocol. Women were evaluated on the 8th postpartum day for the occurrence of pain in the nipple and areola region determined by numerical pain scale, nipple trauma verified by clinical breast examination and breastfeeding technique observed by the breastfeeding assessment form. RESULTS: There was no significant difference between the groups. Pain affected 60.6% of women, of these 60.0% reported pain in both nipples, with predominant onset on the second postpartum day (p = 0.614). For the experimental group there was pain of low intensity, and for the control group moderate intensity (p = 0.276). Less than half of women (40.9%) had nipple trauma (p = 0.211), of these 74.0% had bilateral nipple trauma, beginning on the second postpartum day (p = 0.127). Lanolin associated with breastfeeding health education increases the prevention of nipple pain (RAR 6.1; NTT 21) by 6% and the prevention of nipple trauma (RAR 15.2%; NTT 6) by 15%. In breastfeeding evaluation, all parameters favorable to breastfeeding were observed, except for the condition of the breasts (p = 0.215). CONCLUSION: Anhydrous lanolin combined with health education has positive effects on the prevention of pain and nipple trauma; however, it was not significantly superior to health education on breastfeeding alone.
  • Item
    Estudo da perda e dos fatores associados à densidade mineral óssea de idosos
    (Universidade Federal de Goiás, 2021-03-16) Lima, Brunna Rodrigues de; Pagotto, Valéria;; Pagotto, Valéria; Menezes, Ruth Losada de; Rezende, Marina Aleixo Diniz
    The decrease in bone mineral density (BMD) is associated with complex outcomes such as fractures, which compromise the functionality and quality of life of the elderly The role of some factors such as vitamins D and B12, and bio-chemical tests is not conclusive between genders in the elderly aged 70 years or ol-der, whose decline in BMD may be even greater. Still, in Brazil, there is no evidence from longitudinal studies on the loss of BMD over time. OBJECTIVE: The objecti-ves of this study were: (i) to analyze the profile and factors associated with BMD in elderly over 70 years old, according to sex; (ii) to analyze the loss of BMD in the el-derly in ten years, and the factors that increase its reduction. METHODOLOGY: Prospective cut epidemiological study, with a ten-year follow-up period, carried out in central Brazil. The baseline started in 2008 was composed of 418 elderly people. In 2009, 132 baseline participants were invited to review the DMO. In 2018/2019, all the elderly in the sample being followed up underwent BMD analysis. Thus, for the analysis of the first objective, 175 elderly people were included and for the second objective 79 elderly people with BMD results in two evaluations (2009 and 2018/2019). A home interview was conducted, using a standardized questionnaire by trained researchers. The dependent variable was the BMD analyzed from the dual energy X-ray absorptiometry (DXA) exam, estimated in the spine and femur in g / cm2. The exposure variables were sociodemographic and health conditions. The data were analyzed using the STATA program, version 15.0. To analyze the factors asso-ciated with BMD and loss of BMD, bivariate and multiple analyzes stratified by sex were performed. In the bivariate analysis, a generalized linear model (MLG) of the linear family was used to verify the association between the dependent variable and each independent variable. Variables with p-value <0.20 were included in a final MLG to adjust for potential confounding variables. The magnitude of the association was presented as a regression coefficient (beta) and a 95% confidence interval (95% CI). Variables with p-value <0.05 were considered statistically significant. RE-SULTS: Of the 175 elderly people in the cross-sectional study, 65% were female and 59.4% were between 70 and 79 years old (mean 78.8 years). The overall mean BMD of the spine was 1.064 g / cm2 (± 0.01), with 0.998 g / cm2 in women and 1.186 g / cm2 in men (p <0.001). The general mean BMD of the femur was 0.825 g / cm2 (± 0.12), with 0.774 g / cm2 in women and 0.916 g / cm2 in men (p <0.001). In men, factors associated with appendicular muscle mass, education level, handgrip strength, triglycerides, vitamin D, vitamin B12 and creatinine. In women, appendicular muscle mass, glycated hemoglobin, vitamin B12 were associated with BMD. Of the 79 parti-cipants eligible for BMD loss analysis (cohort study), the overall mean BMD at base-line was 1.147 g / cm2 and after 10 years of follow-up was 0.815 g / cm2. The ave-rage loss of BMD between 2009 and 2019 was -0.341 g / cm2, reflecting a loss of around -29.38%. The loss of BMD was greater in men with a statistically significant difference (p <0.001). CONCLUSION: The present study confirmed that there is a difference in BMD between the sexes and that the factors associated with BMD in the spine and femur may be different. The components of sarcopenia have been positi-vely associated with BMD. Positive association between BMD and glycated hemo-globin, triglycerides and creatinine were controversial with the current literature. The loss of BMD in 10 years was more expressive in men, which suggests that it can oc-cur in this group in later periods. To study the factors related to BMD and how bone mass loss can be prevented by assisting public health policies to avoid outcomes such as fractures, loss of functionality, increased demands for care and costs for the health system.
  • Item
    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;; Barbosa, Maria Alves;; 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.
  • Item
    Letramento em saúde de cuidadores vinculados ao Serviço de Atenção Domiciliar de Goiânia/GO
    (Universidade Federal de Goiás, 2020-05-29) Soares, Thales Antônio Martins; Brasil, Virginia Visconde;; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Borges Júnior, Laerte Honorato
    INTRODUCTION: Health literacy (LS) refers to the skills and capacity of individuals and populations to access, understand and use health information to promote, maintain and make health decisions. Home caregivers with HL limitations are prone to fail in home care due to problems related to poor communication, incomplete health information, inadequate education, limited access to health services and lack of continuity of care. It is believed that the caregiver's HL can influence the way he cares for the person under his responsibility. There are no studies that investigate the LS of home caregivers linked to home care programs, using a multidimensional instrument. OBJECTIVE: to determine the HL conditions of caregivers of people linked to the Home Care Service of Goiânia / Goiás, Brazil. METHODOLOGY: cross-sectional study carried out between March and June 2019 in Goiânia / Goiás, with 90 caregivers linked to the municipality's Home Care Service, interviewed with a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Measures of central tendency and dispersion, HLQ reliability and the Mann Whitney, Kruskal-Wallis tests were used to compare the variables. RESULTS: most caregivers were female (90.0%), had a steady partner (58.89%), lived in the home of those they cared for (75.6%), had a reading habit (57.8% ), was an informal caregiver (91.1%), had parents without schooling (44.2%), studied nine years or more (53.3%) in a public school (84.4%) and had a personal income of up to one minimum wage (72.2%). The type of caregiver, reading habit, living with the patient, having a family income greater than a minimum wage and education of the caregiver and their parents, influenced the HLQ-Br scores. The lowest score in part 1 of the HLQ-Br was found on the “Active health caregiver” scale and the highest on the “Social support for health” scale. In part 2, the lowest score is found on the “Navigating the health system” scale and the highest on the “Understanding health information and knowing what to do” scale. CONCLUSIONS: Income, education and reading habits influenced most HLQ scales. The results can guide the actions of health professionals, who must use the HL construct in their practice. This health indicator helps to improve guidelines for home caregivers, and consequently improve the quality of care. New studies should be carried out to broaden the understanding of HL in this context, to identify how to reduce situational demands, including how services can contribute. LS is broader than the ability to read and understand. It implies the ability to act.
  • Item
    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;; 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.
  • Item
    Intervenções grupais em centros de atenção psicossocial AD
    (Universidade Federal de Goiás, 2020-03-03) Sousa, Johnatan Martins; Esperidião, Elizabeth;; Esperidião, Elizabeth; Luchese, Roselma; Caixeta, Camila Cardoso; Oliveira, Lizete Malagoni de Almeida Cavalcante; Silva, Nathália dos Santos
    The Psychosocial Care Centers Alcohol and Drugs (CAPSad) are institutions that provide assistance to people of any age who experience intense mental distress triggered by the use of alcohol and other drugs. Regarding work processes in CAPS, several professional practices are performed, including group care in their different approaches. Therefore, it is important to analyze the group interventions undertaken by the multiprofessional teams of these community mental health services to analyze the quality of care. This study aimed to promote the educational process, from the perspective of continuing education, with the multiprofessional teams in the CAPSad surveyed, based on analyzed evidence of the practice of professionals. This is a descriptive exploratory research, with a qualitative approach in the parameters of the intervention research, conducted with 30 professionals from four CAPSad of the city of Goiânia. Data collection occurred from March to April 2019. The intervention process occurred in two meetings and was guided by group strategies in the parameters of laboratory education. With the data resulting from the professionals reflection, the thematic content analysis was performed. The thematic categories that emerged from the investigative process were: Challenges of practice with groups; Potentials of practice with groups; Characteristics of group attendance and Demands of Permanent Health Education on group. The results showed that there are many potentialities related to group activities in the CAPS surveyed, although some obstacles need to be faced, both aspects related to professionals and users, as well as their respective work processes. The final stage corresponding to the proposed intervention, in which they became potential multipliers, and were certainly sensitized to care through group technology in a more systematic way. These evidences are essential for the defense of the psychosocial care model in force in the Brazilian scenario.
  • Item
    Iniciativas de segurança na medicação em hospitais do estado de Goiás
    (Universidade Federal de Goiás, 2019-12-11) Sagawa, Marcella Rarumi; Silva, Ana Elisa Bauer de Camargo;; Silva, Ana Elisa Bauer de Camargo; Santos, Patrícia Tavares dos; Alves, Sergiane Bisinoto
    INTRODUCTION: Adverse events associated to the use of medications are a major concern addressed by studies conducted in several countries. Various initiatives have been implemented worldwide to increase medication safety. OBJECTIVE: To investigate initiatives to improve medication safety implemented by hospital institutions in Goiás. METHODOLOGY: Descriptive study carried out in six public hospitals using a semi-structured instrument, containing questions related to the characterization of institutions and 14 safety initiatives in the prescription of medication, nine in the storage, dispensing and distribution of medicines, 25 in the preparation and administration of medicines and two in the transition of care. The study was approved by the Research Ethics Committees of the participating institutions. RESULTS: All hospitals had a Patient Safety Center and anonymous incident notification system; three (50.0%) had quality certification. The average number of safety initiatives in the medication implemented was 8.5 in the prescription process; 8.6 in storage, dispensing and distribution; 16.1 in preparation and administration and 1.3 in the transition of care. Prescription process at all hospitals had drug standardization and information about institutions / patients and safety measures for prescribing potentially dangerous drugs. The standardization of the list of prohibited abbreviations was neither implemented nor planned in five hospitals. In the process of storage, dispensing and distribution of medicines, all hospitals had environmental safety measures and good storage practices in the central pharmacy, standardization of good practices for the separation of medicines, registration and notification of dispensing errors, availability of a pharmacist to review prescriptions, monitoring system and temperature control in specific refrigerators for the storage of thermolabile medicines, and care with storage in the care units. Four hospitals had a unit dose distribution system. All hospitals had a protocol for safe preparation and administration of medications; protocol with mandatory verification items before administration; standardization and verification of patient identification data; checking the prescription immediately after administration; standardization of equipment; return of remnants of medication in the same shift / day and medical records of drug therapy complications. Continuing education and the construction of standards and protocols were actions used to implement initiatives in all hospitals. To maintain the initiatives, hospitals used actions such as the periodic review and updating of institutional protocols (100.0%) and the sharing of incidents among professionals, without exposing those involved (83.3%). About the initiatives evaluation, 28 (56.0%) of the 50 initiatives were evaluated by outcome indicators by at least one of the hospitals. In general, hospitals were satisfied with the adherence of professionals to the initiatives. CONCLUSION: The study shows that hospitals comply with several national and international recommendations for promoting safety in medication processes. However, there is still a need for investments in important initiatives advocated for the prevention of incidents that can cause harm to patients during the medication process.
  • Item
    Fatores de risco cardiovascular em idosos que vivem na comunidade: análise de sobrevida
    (Universidade Federal de Goiás, 2019-12-20) Sousa, Thais Vilela de; Cavalvante, Agueda Maria Ruiz Zimmer;; Cavalcante, Agueda Maria Ruiz Zimmer; Sousa, Ana Luiza Lima; Rezende, Marina Aleixo Diniz
    INTRODUCTION: The already deflagrated aging population process has contributed to changes in the causes of mortality worldwide influencing the increase of chronic noncommunicable diseases. Among the elderly, cardiovascular diseases (CVD) are the main group of chronic diseases because it is the leading cause of death in this population. The presence of cardiovascular risk factors (CVRF) impacts the morbidity and mortality of these individuals increasing the risk for cardiovascular events promoting pathological aging and death. Factors such as smoking, alcohol consumption, hypertension, dyslipidemia, diabetes mellitus, obesity and physical inactivity contribute to the reduction of survival in this population. OBJECTIVE: To analyze the relationship between cardiovascular risk factors and survival of elderly people living in the community over a 10-year period. METHOD: Survival analysis in a prospective cohort with 418 community-dwelling older adults living in the urban area of ​​Goiânia. They were evaluated at baseline in 2008 for sociodemographic characteristics (gender, color, age, marital status and social class), clinical (hypertension, systolic and diastolic blood pressure, diabetes mellitus, glycated hemoglobin, fasting glucose, dyslipidemia, low density lipoprotein, high density lipoprotein, body mass index and waist circumference) and lifestyle (physical activity level, smoking and alcohol consumption). After 10 years of follow-up, in 2018, the elderly survivors and those who died were compared and the groups of survivors compared to those who died from CVD and other causes according to the presence of CVRF to identify variables associated with CVD death. Associations were estimated by Pearson chi-square test, Student t test, ANOVA and Bonferroni tests. Survival was estimated at two, four, six, eight and 10 years by the Kaplan Meier method and the Logrank test and considering the significance level of 5%. Cox regression was performed to verify factors associated with survival time and to estimate the risk of death from CVD expressed as Hazard Ratio (HR) with a 95% confidence interval. RESULTS: Most of the elderly were female (66.0%), white (46.4%), married (54.8%) and with low education (3.4 years of schooling), predominantly hypertensive (81.6 %), irregularly active (44.0%) and former smokers (43.3%). The main risk factors for death from CVD were: age (HR: 1.067 CI: 1.027-1.1009), hypertension (RH: 3.178 CI: 1.144-8.826) and smoking (RH: 2.235 CI: 1.253-3.987). Being sedentary was a risk factor for reduced survival, increasing the odds of death 2.4 times. CONCLUSION: Factors such as older age, being hypertensive, smoker at some point in life and sedentary were risk factors for death from CVD. This study provided insight into the cardiovascular risk of aging over a ten-year period. Research is recommended to clarify not only the relationship between CVRF and mortality, but also to develop better interventions that reach this population resolutely, providing quality aging and autonomy.
  • Item
    Conhecimento de profissionais e trabalhadores da saúde sobre o processo de doação e transplante de órgãos e tecidos
    (Universidade Federal de Goiás, 2019-12-04) Calixto, Anaian Carla Vieira; Barreto, Regiane Aparecida dos Santos Soares;; Barreto, Regiane Aparecida dos Santos Soares; Cordeiro, Jacqueline Andreia Bernardes Leão; Suzuki, Karina; Pagotto, Valéria; Gonçalves, Fernanda Alves Ferreira
    The number of transplants has increased considerably in recent years, but there are still numerous barriers and difficulties to be faced. The population is known to lack considerable numbers of effective organ and tissue donors. It is essential that the multiprofessional assistant team in this area is constantly trained and trained. The aim of this study was to analyze the knowledge of health professionals and workers about organ and tissue donation and transplantation. From July 2018 to January 2019 a quantitative cross-sectional analytical study was conducted with 250 health professionals and workers. Data collection was performed through a structured questionnaire with 18 closed questions related to the knowledge of health professionals and workers about the aspects of organ and tissue donation and transplantation in Brazil prepared by the researchers Freire et al. The collected data were analyzed using STATA software, version 12.0. Most participants demonstrated knowledge about the non-obligatory donation, non-commercialization of organs and tissues in the country, deceased donor with beating heart, deceased donor with stopped heart and concept of ME. Participants showed no knowledge of the concept of living donor. Few professionals have stated intention to donate. There was an association between the intention to donate in females, participants with higher education and those who reported higher monthly income. There was an association with the intention to donate in the participants who were able to answer correctly about informing the family as a criterion to be a donor, non-commercialization of organs and tissues in the country, the concept of a deceased donor with a beating heart, and the existence of the National Transplant System and in those. participants who could not respond to the concept of living donor. Although organ and tissue donation is a current theme, it is still poorly understood by the general population and by health professionals and workers as a result of several cultural reasons and paradigms dragged on for years cited throughout this study. The need to raise awareness along with the implementation of educational programs among health professionals on organ donation and transplantation is evident.
  • Item
    Cultura de segurança do paciente em um hospital regional goiano
    (Universidade Federal de Goiás, 2019-12-11) Sousa, Jéssica Cezario de; Barreto, Regiane Aparecida dos Santos Soares;; Pagotto, Valéria; Luciano, Cristiana da Costa; Bezerra, Ana Lúcia Queiroz; Almeida, Carlos Cristiano Oliveira de Faria
    Introduction: According to the World Health Organization, Patient Safety is characterized as reducing the risk of unnecessary harm associated with health care to an acceptable minimum. Patient Safety Culture is described as a product of values, attitudes, skills and behavioral patterns that determine the commitment, style and proficiency of running a healthy and safe organization. Objective: The aim of this study was to analyze the PSC from the perspective of the health team of a public regional hospital in the state of Goiás. Methods: We applied the Hospital Survey of Patient Safety Culture (HSOPSC) questionnaire adapted and validated for Portuguese. The percentage frequency of each dimension was calculated and classified into area of strength, neutral area and area with potential for improvement for Patient Safety. Results: The target population consisted of 197 workers and health professionals from the studied hospital, of which 152 answered the questionnaire. The health team of the institution studied was mainly composed of females, aged between 40 and 49 years, with completed high school and with specialization. Most respondents to this survey were health workers (44.7%), followed by technical health professionals (27.6%) and higher-level health professionals (27.6%). The dimensions of the HSOPSC questionnaire that received the most positive responses and were classified as “neutral areas” were: “organizational learning”, “safety direction expectations” and “teamwork in the unit”. All other dimensions were classified as “areas with potential for improvement” for Patient Safety. Most respondents (82%) reported no adverse events in the last 12 months. In general, higher-level health professionals had a worst perception about the dimensions presented in the questionnaire. Most respondents rated patient safety as "very good" or "fair" in the hospital studied. Conclusion: We concluded that this hospital has a fragile Patient Safety Culture from the perspective of the health team, with most dimensions showing potential for improvement and no area of ​​strength. Such evidence serves to reinforce the strategy planning for Patient Safety in this institution.
  • Item
    Inquérito soroepidemiológico e estado vacinal para hepatite B em agentes de segurança prisional de cinco unidades prisionais de Goiás
    (Universidade Federal de Goiás, 2019-07-09) Vieira, Camila Canhete Ferreira; Pessoni, Grécia Carolina;; Matos, Marcos André de;; Freitas, Nara Rubia de; Luciano, Cristiana da Costa; Matos, Marcos André de
    Hepatitis B virus infection (HBV), although for decades being immunopreventable, remains a challenge for health surveillance, especially when it comes to some professional categories. Data focusing this problematic among the workers of Brazil’s prison system are non-existent, being this dissertation the first study of the kind to be held in the country, and whose aim is to investigate the epidemiology of hepatitis B virus infection and the vaccine situation concerning Prison Security Agents (PSA) of five prison facilities in the state of Goiás. Therefore, 282 individuals were interviewed in order to understand their sociodemographic characteristics, labor aspects, vaccination against hepatitis B and factors associated to the HBV. Subsequently, clinical specimens were collected for the HBsAg, antiHBc and anti-HBs in order to be detected by the immunoenzymatic assay (ELISA). The data were analyzed by the STATA program, 14.0 version. Prevalence rates were calculated with a confidence interval of 95% (CI 95%), as well as the Adjusted Prevalence Ratio (AdjPR) of the individuals exposed to the HBV (anti-HBc positive) associated to the investigated factors. As for the logistic regression, multiple Poisson regression models with robust variance were used. It was detected that 3.9% (95% CI: 2.2-6.9) of the individuals had anti-HBc in isolation; 3.6% (95% CI: 2.0-6.5) presented it while associated to anti- HBs, resulting in a global prevalence of hepatitis B virus infection of 7.5% (95% CI: 5.0-11.2). Nevertheless, it was verified a high rate (50,6%, CI 95%: 44,7 -56,4) of workers who were susceptible to the HBV. The multiple regression model showed that factors such as being female (AdjPR: 3,10, 95% CI: 1.04-6.28), working in temporary prison facilities (AdjPR: 7.38, 95% CI: 2.26- 24,03), experiences with acupuncture (AdjPR: 2.20, 95% CI: 1.05-4.62) and sexual violence (AdjPR: 11.42, 95% CI: 3.64-35.86) were associated with HBV exposure. On the other side, age, number of sexual partners and previous testing for hepatitis B were associated with previous vaccination against HBV. Finally, little compliance of the vaccination report with positivity to the isolated anti-HBs was verified. These results are worth noting considering they have the potential to provide information on the gaps of planning programmatic measures to reduce the vulnerability of these individuals to hepatitis B virus infection.
  • Item
    A amamentação e o leite materno para o alívio da dor de procedimentos em recém-nascidos pré-termo: revisão sistemática
    (Universidade Federal de Goiás, 2019-07-29) Freitas, Raquel Rodrigues de; Castral, Thaíla Corrêa;; Castral, Thaíla Corrêa; Bueno, Mariana; Cavalcante, Marcela Maria Faria Peres 
    Introduction: Preterm newborns in the Intensive Care Unit are exposed to different painful procedures. It is recommended that units providing care to the newborn should establish a pain management program, which includes non-pharmacological analgesic interventions. Breastfeeding in full-term newborns is effective in reducing pain responses, but the evidence for preterms is still inconclusive. Objective: To evaluate and synthesize the literature on the evidences of the effectiveness of breastfeeding or breast milk as non-pharmacological interventions for the management of acute procedural pain in preterm newborns. Methods: Systematic review of randomized clinical trials published between 2011 and 2018 in English, Spanish and Portuguese. Search performed according to the acronym PICO, with the research question: Are breastfeeding and breast milk effective in the management of acute pain of procedures in preterm newborns compared to other non-pharmacological methods. Pain was assessed as the predicted value, considering at least one of the following results: scoring of pain assessment scales and evaluation of physiological, behavioral pain indicators or other indicators. The search performed in the electronic databases of MEDLINE, CENTRAL and LILACS, using controlled terms for preterm newborn, pain, breastfeeding, breast milk and randomized clinical trial. Study methodological quality was assessed using the Cochrane Collaboration tool for bias risk assessment from randomized clinical trials. Results: Fifteen studies were included, and two evaluated the use of breastfeeding (128 preterms) and thirteen (1026 preterms) the use of breast milk as an analgesic intervention. The endpoint evaluated in most of the studies (n= 12, 80%) was the PIPP score. The painful procedures examined were heel puncture, ophthalmologic examination for retinopathy of prematurity, aspiration of the airways, removal of adhesive tape from dressing and venipuncture. Conclusion: Breastfeeding has an analgesic effect on heel puncture for late preterm newborns that demonstrate ability to breastfeed. It did not present significant differences in relation to then onnutritive suction and sucrose 24%. Breast milk has a superior effect in relation to water and no treatment, and it shows better results when combined with nonnutritive suction, kangaroo position and enrollement, and is recommended for pain reduction during heel puncture. Studies should be done to investigate other factors that interfere with the efficacy of breastfeeding, such as maternal factors and breastfeeding time, and in addition to investigate different dosages of milk that ensure the best dose / effect to promote analgesia.
  • Item
    Imunogenicidade e reatogenicidade da vacina contra hepatite B derivada de Hansenula polymorpha comparada a Saccharomyces cerevisiae em homens privados de liberdade
    (Universidade Federal de Goiás, 2019-04-30) Sandim, Lucíola Silva; Matos, Marcos André de;; Matos, Marcos André de; Pessoni, Grécia Carolina; Carmo, João Paulo Martins do
    Hepatitis B virus infection still poses a serious threat to global health, since there is no "virological cure" and vaccination, considered the main pillar of eradication of the disease, did not reach the coverage rates recommended. The objective of this study was to evaluate the response of the hepatitis B vaccine to men deprived of their liberty from a prison in the state of Goiás, Central Brazil, comparing a vaccine with Hansenula polymorpha expression system to Saccharomyces cerevisiae. The participants were divided into two groups - Group 1 (SERUM - Hansenula polymorpha) and Group 2 (EUVAX - Saccharomyces cerevisiae). Vaccines were administered at months 0, 1 and 6. The Geometric Mean (MGT) of anti- HBs after the third dose of the vaccine was 656.1 (95% CI: 446.6, 972.7) of G1 and 203.7 (95% CI: 69.3, 597.0) of G2. Unadjusted analysis showed that G1 MGT was statistically higher than that observed in G2 (p-value = 0.075). The seroconversion rate (anti-HBs titers> 10 mIU / mL) was 100% for G1 and 82.8% for G2, with a trend toward higher seroconversion in G1 than G2 (p-value = 0.058). HIV infection (RTIaj 3.76, p-value = 0.035) and obesity (RTIaj 4.95, p-value = 0.017) were associated with inadequate vaccine response. Regarding reatogenicity, there was no statistical difference between groups (p-value = 0.501). Evidence from this investigation shows that the two vaccines, with different expression systems, were satisfactory in this clinical trial, although all nonresponders belonged to group 2 with Saccharomyces cerevisiae expression system. It is believed to be important to continue monitoring the performance of these vaccines in adults with a view to improving their immunogenicity, by assessing the factors that interfere with the vaccine response.
  • Item
    Perfil epidemiológico do vírus da hepatite B em adultos e idosos de um município de pequeno porte de Goiás
    (Universidade Federal de Goiás, 2019-03-11) Brandão, Leyla Gabriela Verner Amaral; Teles, Sheila Araújo;; Caetano, Karlla Antonieta Amorim;; Caetano, Karlla Antonieta Amorim; Teles, Sheila Araújo; Pagotto, Valéria; Oliveira, Michele Dias da Silva; Carneiro, Megmar Aparecida dos Santos
    In Brazil, current trends in the epidemiology of hepatitis B show a shift in its profile, indicating an increase among elderly populations. We conducted a cross-sectional and analytical study in order to investigate the epidemiological profile of the hepatitis B virus (HBV) in adult and elderly residents of a small-sized municipality in the Southeast region of the state of Goiás. Data were gathered between July and August 2017, and 445 individuals aged 40 and over were recruited. All participants were interviewed and tested for serologic markers of hepatitis B (HBsAg, anti-HBs and anti-HBc) by means of an immunoenzymatic assay (ELISA). Reactive HBsAg samples were tested for serologic markers of HBeAg, anti-HBe, and anti-HBclgM, as well as for HBV DNA through semi-nested PCR. We carried out bivariate and multiple analyses by means of logistic regression in order to identify the association between HBV exposure and sociodemographic and behavioral variables. Study participants included mostly females (61.8%), of which nearly half (44.3%) were aged 60 and over, and 57.5% were married or in consented relationships. As for education, over 60% had over 5 years of schooling. Regarding their place of residence, 11% dwelt in the countryside. Sixty-six participants presented at least one HBV exposure serologic marker adding up to a global prevalence of 14.8% (IC95%: 11.7% - 18.5%), whereas HBsAg prevalence was 0.6% (IC95%:0.2% -2.0%). Our findings show that variables such as being 50-59 (p=0.023) and ≥ 60 years of age (p=0.007), dwelling in the countryside (p=0.009), having a history of genital warts (p=0.034), and having sexual intercourse with sex workers (p=0.023) were significantly associated with HBV exposure. We identified a knowledge gap regarding the parenteral transmission of the virus among the participants, with 42.7% being unaware of the risk of HBV transmission through the shared used of razor blades, and 38.4% of the risk of transmission of viral hepatitis during surgical procedures. At last, three study participants tested positive for HBsAg indicating active hepatitis B infection. Risky parenteral and sexual behaviors were identified among the carriers, which contributes effectively to HBV transmission. Results highlight the necessity for effective preventive measures of hepatitis B targeting the elderly and corroborate individual, social and programmatic vulnerability. To do so, ongoing awareness campaigns for health care providers with emphasis on STDs prevention for individuals in their forties are necessary.