Percepção dos usuários sobre o programa de saúde da família : um contributo para a reflexão

A Estratégia Saúde da Família apresenta-se como uma possibilidade de reestruturação da atenção primária, a partir de um conjunto de ações conjugadas em sintonia com os princípios de intersetorialidade, descentralização, equidade, coresponsabilidade e priorização de grupos populacionais com maior risco de adoecerem ou morrerem. Assim, este estudo objetivou caracterizar a percepção dos usuários da Unidade Básica de Saúde da Família (UBSF) sobre o Programa Saúde da Família (PSF). Trata-se de um estudo qualitativo desenvolvido na USF Barra de Sirinhaém, do Estado de Pernanbuco. Para tanto, contou-se com a participação de 54 usuárias do sexo feminino. Estas responderam a um formulário sócio-demográfico e um roteiro de entrevista semi-diretiva. Os discursos foram submetidos a análise de conteúdo à luz da literatura pertinente. Os principais resultados mostraram que a percepção das usuárias acerca do Programa de Saúde Familiar é de que este ainda funciona com abordagem curativa, mas que possuem maior acessibilidade e construíram um vínculo mais efetivo com os profissionais de saúde. Diante do exposto infere-se que a estratégia de saúde da família ainda não se concretiza pela dificuldade das pessoas entenderem a filosofia do programa, ainda polarizarem uma visão hospitalocêntrica da saúde e revelaram um certo alheamento da compreensão do significado do PSF. Palavras-chave: Estratégia Saúde da Família; Percepção; Assistência à Saúde.

Quality of life and chronic disease in patients receiving primary health care

Problem Statement: Chronic disease entails physical, psychological and social issues with a decrease in the quality of life. The assessment of QoL has been applied as indicator in patients with chronic diseases. Research Questions: What is the quality of life in patients with chronic disease? What are the socio-demographic variables that influence the quality of life in patients? Purpose: To assess the quality of life in patients suffering from chronic disease and identify socio-demographic variables which influence the quality of life of patients suffering from chronic disease. Research Methods: We conducted a cross-sectional analytical study using a sample composed of 228 users (134 females) from a Family Health Unit in the municipality of Viseu. Data collection was made by means of a questionnaire, consisting of sociodemographic variables, the SF-12 scale and the existence of chronic disease was assessed through the questions – “Do you currently suffer from any chronic disease?”; “If so, which one(s)?”. Findings: The most common chronic diseases were hypertension (59.9%). Female patients with a chronic disease reported worse physical functioning, role-physical and role-emotional; increased bodily pain and better quality of life regarding general health. Male patients showed worse role-physical, increased bodily pain and vitality. Sociodemographic variables which were associated with quality of life were area of residence, academic qualifications and work situation. Conclusion: Chronic disease affects quality of life negatively. Quality of life in both patients groups was associated with socio-demographic variables. Health-related quality of life is an essential issue and should be considered as a priority in health policies.

Segurança rodoviária infantil : conhecimentos e atitudes dos pais na utilização do sistema de retenção no recém-nascido

Enquadramento: A segurança é um direito da criança, que deve ser assegurado pelos pais e sociedade em geral, pois devido à sua vulnerabilidade estão sujeitas a um maior risco de lesões e morte. O transporte seguro de recém-nascidos/crianças em automóveis é uma preocupação, pois os acidentes de viação são a principal causa de mortalidade e morbilidade nesta faixa etária. Nos acidentes rodoviários, o uso correto de um sistema de retenção para crianças (SRC), desde o nascimento, constitui uma forma eficaz de proteção. Objetivos: Caracterizar os conhecimentos e atitudes dos pais no uso do SRC; analisar a influência do processo de aquisição e de informação dos pais sobre o uso do SRC; identificar a relação entre as variáveis sociodemográficas dos pais e o uso de SRC; determinar se os conhecimentos são mediadores das atitudes dos pais na utilização do SRC. Métodos: Estudo quantitativo, transversal, descritivo e correlacional, realizado numa amostra não probabilística, por conveniência de 112 pais de recém-nascidos, mães com média de idade de 30,37 anos (Dp=5,63) e pai 33,91 (Dp=6,09). Para recolha de informação utilizou-se um questionário, construído para o efeito, que os pais preencheram 24-48h após o parto durante os meses de março a maio de um centro hospitalar da região norte de Portugal. Resultados: Maioritariamente tinham como escolaridade o ensino secundário e entre 1 a 4 filhos. O SRC fazia parte do ―enxoval‖ do bebé em 54,5% dos participantes, destes, 72,3% já o tinha experimentado no automóvel e pretendiam usá-lo na alta desde a maternidade 97,3%. Contudo, apurou-se que apenas 47,3% o faria de forma adequada, apesar de 83% referir conhecer a legislação e todos reconhecerem que previne lesões em caso de acidente e 67% admitir ter conhecimentos adequados sobre SRC. Concluiu-se haver relação entre os conhecimentos e a idade e a escolaridade das mães, e pelos resultados obtidos, inferimos que melhores conhecimentos conduzem a melhores atitudes na utilização do SRC. Conclusões: Os resultados indicam que os conhecimentos dos pais sobre o uso adequado de SRC continuam insuficientes. Este facto justifica o investimento no ensino, treino e preparação dos pais para a alta segura desde a maternidade, momento particularmente sensível, e que será determinante nas atitudes de promoção da segurança rodoviária das crianças e adolescentes. Palavras-chave: Segurança; Recém-nascido; Sistema de retenção; Conhecimentos; Atitudes.

First evidence of Schmallenberg virus introduction in Portugal, 2014

Objectives: Serra da Estrela native (SEN) breed of sheep is one of the most important in Portugal, standing responsible for the production of one of the most internationally recognized cheeses in the world, "Queijo Serra da Estrela” (protected designation of origin). One of the major risks to the sustainability of SEN dairy flocks if footrot, an infectious diseases that causes lameness, decrease in milk production, weight loss and decrease in fertility. The aim of this work was to determine which parameters become decisive for the appearance of footrot in SEN dairy flocks, while establishing associations with environmental and nutritional variables. Materials and Methods: The present study was carried out by performing an especially designed 27 multiple choice questionnaire, based on the underlying causes of lameness in livestock and in the clinical diagnosis performed by the vet techinichian of the clinical cases evaluated at the moment of the inquiry. The survey was performed during the execution of the oficial veterinary health program between February and September of 2014 by a veterinarian team from the Association of SEN Sheep Breeders (ANCOSE). The ovine producers (N=30, with a total of 1270 animals) were randomly selected from the extense area of production of “Queijo Serra da Estrela”. The parameters evaluated in the study were: season and consequent weather changes during the period of the study, floor types, hygiene conditions, bed types, the existence and use of footbaths, location of footbaths, foot trimming and foot hygiene procedures. After the construction of the database and using the Statistical Package for Social Sciences version 16.0 the frequency response for each item was calculated. Results: All SEN livestock producers are proactive in the treatment of lameness (70%). About 99.7% of lameness was related with footroot and most appeared in winter (36.7%). In some occasions there was not a specific season distribution (56.7% rainiest years). From the analyzed farms, 70% use straw as a floor bed, followed by bush (21%). 45.6% of animals were clinically diagnosed with footrot and were sheltered in straw floor. Bed quality is good in 40%, however frequent changes in the floor bed in the preceding 15 days had a higher rate of footroot diagnosed cases (33,23%) compared to monthly changes. Regarding sheepfold animal number, the distribution is proper in 36.7%, elevated in 30%, overcrowded in 6.7% and low in 23.3%. Clinically ill diagnosed animals in last category were the lowest observed (3%). Concerning hoof trimming, 76.7% trims while 23.3% reported not to perform that task. From those that perform trimming, 73.9% do it only when necessary, 21.7% at the time of clipping and 4.4% when the animal is affected. One curious result was that animals who perform trimming at clipping had higher footrot cases (52.6%), unlike those who trim only when necessary (40.2%) or even when animals are clinically ill (0.91%). Mostly all in the presence of footrot choose a local treatment (95.2%) using antibiotic sprays, instead of parenteral antibiotic treatment. Footbath is rarely used in the prevention (13.3%) of this disease and when it is misconceived (25%) and incorrectly formulated (100%). Conclusions: This study was the first performed in Portugal focusing footrot caracterization in native SEN flocks.Economic impact in SEN dairy flocks is atributed to factors such as direct decrease in milk and meat production,early slaughter of affected animals due to non responsive treatment and medical expenses.The most effective eradication method combines first of all the ability to understand the problems of SEN producers and implementation of preventive measures and treatment of footrot.Often linked to lack of formation, the advance age of portuguese producers the mentality and social factors block the advance of veterinarian intervention itself.

Footrot caracterization in serra da estrela native flocks

Objectives: Serra da Estrela native (SEN) breed of sheep is one of the most important in Portugal, standing responsible for the production of one of the most internationally recognized cheeses in the world, "Queijo Serra da Estrela” (protected designation of origin). One of the major risks to the sustainability of SEN dairy flocks if footrot, an infectious diseases that causes lameness, decrease in milk production, weight loss and decrease in fertility.The aim of this work was to determine which parameters become decisive for the appearance of footrot in SEN dairy flocks, while establishing associations with environmental and nutritional variables. Materials and methods: The present study was carried out by performing an especially designed 27 multiple choice questionnaire, based on the underlying causes of lameness in livestock and in the clinical diagnosis performed by the vet techinichian of the clinical cases evaluated at the moment of the inquiry. The survey was performed during the execution of the oficial veterinary health program between February and September of 2014 by a veterinarian team from the Association of SEN Sheep Breeders (ANCOSE). The ovine producers (N=30, with a total of 1270 animals) were randomly selected from the extense area of production of “Queijo Serra da Estrela”. The parameters evaluated in the study were: season and consequent weather changes during the period of the study, floor types, hygiene conditions, bed types, the existence and use of footbaths, location of footbaths, foot trimming and foot hygiene procedures. After the construction of the database and using the Statistical Package for Social Sciences version 16.0 the frequency response for each item was calculated. Results: All SEN livestock producers are proactive in the treatment of lameness (70%). About 99.7% of lameness was related with footroot and most appeared in winter (36.7%). In some occasions there was not a specific season distribution (56.7% rainiest years). From the analyzed farms, 70% use straw as a floor bed, followed by bush (21%). 45.6% of animals were clinically diagnosed with footrot and were sheltered in straw floor. Bed quality is good in 40%, however frequent changes in the floor bed in the preceding 15 days had a higher rate of footroot diagnosed cases (33,23%) compared to monthly changes. Regarding sheepfold animal number, the distribution is proper in 36.7%, elevated in 30%, overcrowded in 6.7% and low in 23.3%. Clinically ill diagnosed animals in last category were the lowest observed (3%). Concerning hoof trimming, 76.7% trims while 23.3% reported not to perform that task. From those that perform trimming, 73.9% do it only when necessary, 21.7% at the time of clipping and 4.4% when the animal is affected. One curious result was that animals who perform trimming at clipping had higher footrot cases (52.6%), unlike those who trim only when necessary (40.2%) or even when animals are clinically ill (0.91%). Mostly all in the presence of footrot choose a local treatment (95.2%) using antibiotic sprays, instead of parenteral antibiotic treatment. Footbath is rarely used in the prevention (13.3%) of this disease and when it is misconceived (25%) and incorrectly formulated (100%). Conclusion: This study is the first performed in Portugal focusing on footrot caracterization in native SEN flocks. The economic impact in SEN dairy flocks is atributed to factors such as the direct decrease in milk and meat production, the early slaughter of affected animals due to a non responsive treatment, and medical expenses. The most effective eradication method combines first of all the ability to understand the problems of SEN producers and then the implementation of preventive measures and treatment of footrot. Often linked to the lack of formation, and the advanced age of portuguese producers, the mentality and social factors block the advance of veterinarian intervention itself.