Conhecimento dos enfermeiros do Hospital Universitário Onofre Lopes sobre sistematização da assistência de Enfermagem

Nursing as a profession goes in search on quality of their care through new frameworks, trying to break postures of the health care system so fragmented in the care. To change professional practices, it is necessary to build their own knowledge grounded on Nursing Care System. The aim of this study was to analyze the influence of nurses' knowledge on care systematization in nursing in the University Hospital Natal-RN. It is an analytical descriptive study carried out at the Onofre Lopes University Hospital (HUOL), Natal-RN, 2010, the sample was composed of 40 active nurses working in hospitalization units of the hospital, the inclusion criteria were being in the monthly scale sector and agree to participate in the study. The non-participant observation and another interview were used for collecting data, statistical analysis was descriptive and inferential with reliability test, Pearson test, chi-square and Fischer, the variables that correlated were analyzed in a model Multiple logistic , calculating odds ratio. The results were: predominance of female professionals (90%), predominantly in the age range 39-46 years (37.5%), nurses who have the undergraduate degree at the Federal University of Rio Grande do Norte (80%), and who have expertise training as a minimal degree (62.5%). Among the surveyed, the knowledge showed significance with the graduation time (p = 0.018) and time working in HUOL (p = 0.036). The majority of the professionals surveyed do not know which organ is responsible for the SAE legislation (52.5%), aware of the steps needed to build the nursing diagnosis (92.5%), understand the characteristics of nursing planning (90% ). However the same professionals do not perform physical examination in patients (50.0%) did not classify the clinical findings (68.4%), and identify the problems encountered as a classification (13.2%). The planning of nursing care is carried out by verbal order of nurses (82.5%), 41% of the professionals assess only the intervention stage, in other words, the actions taken. Regarding the practical application of nursing records 53% of nurses do not realize records, 30.8% is incomplete, the other held notes (p = 0.003). The nurses know the nursing process (90% of appropriate responses), despite the actions defined by the theory are not applied in practice. Investigators believe the condition of the hospital teacher (22.5%) could positively affect the implementation of the SAE associated with the interest of professionals (20%). Of the respondents, 17.5% accept as truth the lack of facilities to assist the SAE implementation in the hospital. It was concluded that nurses know the theory that underlies the SAE and the nursing process, but do not develop the service know as well, there is need for action to boost the SAE implementation as practice of nurses in the hospital investigated

Análise de desempenho de vendas em telecomunicações utilizando técnicas de mineração de dados

Nowadays, telecommunications is one of the most dynamic and strategic areas in the world. Organizations are always seeking to find new management practices within an ever increasing competitive environment where resources are getting scarce. In this scenario, data obtained from business and corporate processes have even greater importance, although this data is not yet adequately explored. Knowledge Discovery in Databases (KDD) appears then, as an option to allow the study of complex problems in different areas of management. This work proposes both a systematization of KDD activities using concepts from different methodologies, such as CRISP-DM, SEMMA and FAYYAD approaches and a study concerning the viability of multivariate regression analysis models to explain corporative telecommunications sales using performance indicators. Thus, statistical methods were outlined to analyze the effects of such indicators on the behavior of business productivity. According to business and standard statistical analysis, equations were defined and fit to their respective determination coefficients. Tests of hypotheses were also conducted on parameters with the purpose of validating the regression models. The results show that there is a relationship between these development indicators and the amount of sales

Avaliação de programa de ginástica laboral e desempenho funcional: um estudo em empresa distribuidora de energia elétrica

This thesis treats of a avaliation of a laboral gimnastics program of a electrical energy enterprise from Rio Grande do Norte. The leading aim of this work is to analyse the laboral gimnastics program with emphasis on functional performing and personal changes of staff of different categories. The work shows two divisions: at first, it was carried out the bibliographic study approaching the concepts and historic about the ergonomy and the main focus of study, the laboral gimnastics , performing factors and lifestyle.The second time , it was carried out the field study where was used a questionnaire to a 160 staff population which participate of laboral gymnastics program; then the data were analysed through three statistics analyses: multivaried__ clusters, qui-quadrado and multiple linear regression. The results aim to the confirmation that the laboral gymnastics program developed two years ago on enterprise proposes to the white-collar and operational workers an improving on their functional performing and also, to the changes in some aspects of lifestyle, like the food, leisure and stress level. In conclusion, it was checked that the investiment in life quality programs offer benefits both to the staff and the enterprise which will account with good services and satisfaction of customer. Therefore, it was concluded that the laboral gymnastics while a ergonomic tool and a physical activity, it is an investiment which needs more and more to be strengthened and inserted by many segments of society

Valores de referência para pressão inspiratória nasal SNIFF na população brasileira

The strength of respiratory muscle are frequently assessed by maximal inspiratory and expiratory pressure, however, the maneuvers to assess PImax and PEmax are difficult for many patients. The sniff nasal inspiratory pressure (SNIP) is a simple and noninvasive technique use to assess inspiratory muscles strength. Reference values have been previous established for SNIP in adults but no previous studies have provided reference values for SNIP in adult Brazilian population. The main objective of this study were propose reference values of SNIP for Brazilian population through establishment of relationship between anthropometric measurements, physical activity profile and SNIP and at the same time compare the values obtained with reference values previously published. We studied 117 subjects (59 male and 58 female) distributed in different age grouped 20-80 years old. The results showed on significant positive relationship between SNIP and height and negative correlation with age (p<0.05). In the multiple linear regression analysis only age continued to have an independent predictive role for the two dependent variables that correlated with SNIP. The values of SNIP found in Brazilian population were higher when compared with predict values of previous studies. The results of this study provide reference equations of SNIP for health Brazilian population from 20 to 80 years old

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Equações preditivas para as pressões respiratórias máximas de crianças brasileiras

I ntroduction: The assessment of respiratory muscle strength is important in the diagnosis and monitoring of the respiratory muscles weakness of respiratory and neuromuscular diseases. However, there are still no studies that provide predictive equations and reference values for maximal respiratory pressures for children in our population. Aim: The purpose of this study was to propose predictive equations for maximal respiratory pressures in healthy school children. Method: This is an observational cross-sectional study. 144 healthy children were assessed. They were students from public and private schools in the city of Natal /RN (63 boys and 81 girls), subdivided in age groups of 7-8 and 9-11 years. The students presented the BMI, for age and sex, between 5 and 85 percentile. Maximal respiratory pressures were measured with the digital manometer MVD300 (Globalmed ®). The maximal inspiratory pressure (MIP) and maximal expiratory pressures (MEP) were measured from residual volume and total lung capacity, respectively. The data were analyzed using the SPSS Statistics 15.0 software (Statistical Package for Social Science) by assigning the significance level of 5%. Descriptive analysis was expressed as mean and standard deviation. T'Student test was used for unpaired comparison of averages of the variables. The comparison of measurements obtained with the predicted values in previous studies was performed using the paired t'Student test. The Pearson correlation test was used to verify the correlation of MRP's with the independent variables (age, sex, weight and height). For the equations analysis the stepwise linear regression was used. Results: By analyzing the data, we observed that in the age range studied MIP was significantly higher in boys. The MEP did not differ between boys and girls aged 7 to 8 years, the reverse occurred in the age between 9 and 11 years. The boys had a significant increase in respiratory muscle strength with advancing age. Regardless sex and age, MEP was always higher than the MIP. The reference values found in this study are similar to a sample of Spanish and Canadian children. The two models proposed in previous studies with children from other countries were not able to consistently predict the values observed in this studied population. The variables sex, age and weight correlated with MIP, whereas the MEP was also correlated with height. However, in the regression models proposed in this study, only gender and age were kept exerting influence on the variability of maximal inspiratory and expiratory pressures. Conclusion: This study provides reference values, lower limits of normality and proposes two models that allow predicting, through the independent variables, sex and age, the value of maximal static respiratory pressures in healthy children aged between 7 and 11 years old

Sono e síndrome da fragilidade em idosos residentes em instituições de longa permanência

Introduction: The aging process causes quantitative and qualitative changes in sleeping. Such changes affects more than half of the adults above 65 years old, that live in the community and 70% of the institutionalized, a great negative impact in their quality of life. One of the pathological displays of aging, that share some characteristics with sleeping disorders and predict similar results, is the Frailty Syndrome, that characterize the most weakened and vulnerable elderly. The way sleeping disorders play a role in the frailty pathogeneses remains uncertain. Objective: Evaluate the relation between the sleeping and the frailty syndrome on institutionalized elderly. Methodology: A transversal study was performed with 69 elderly in institutions in the city of João Pessoa PB. Were used the Pittsburgh Sleeping Quality Index and actigraphy to subjective and objective variables, respectively, and questionnaires and specific tests to frailty phenotype variant (Fried Frailty Criteria). In the statistic analysis were used the Pearson correlation test, Chi Square and One-way ANOVA test, with Tukey-Krammer posttest. Subsequently, a Simple Linear Regression model was built. On every statistical analysis were considered a confidence interval of 95% and a p < 0,05. Results: The sample was characterized by the prevalence of the frail (49,3%), women (62,3%), single (50,7%) and 77,52 (±7,82).The frail elderly obtained the worst sleeping quality 10,37 (±4,31) (f = 4,15, p = 0,02), when compared with the non-frail. The sleep latency influenced more the frailty (R2 = 0,13, β standard = 1,76, β = 0,41, p = 0,001). Weren t found differences between the standard resting-activity variable and the frailty phenotype categories. Conclusion: Sleeping alterations, including bad sleeping quality, prolonged sleep latency, low sleep efficiency and day drowsiness, influenced the frailty in institutionalized elderly

Equacões preditivas para as pressões respiratórias estáticas máximas de adolescentes brasileiros

Introduction: The reference values and prediction equations for maximal respiratory pressures (MRP) differ significantly between the available studies. This large discrepancy can be attributed to the different methodologies proposed. Although the importance of MRP is widely recognized, there are no Brazilian studies that provide predictive equations and reference values for PRM adolescents. Objectives: The purpose of this study was to provide normal values and propose predictive equations for maximal static respiratory pressures of Brazilian adolescents. Methods: An observational cross-sectional study, which evaluated 182 adolescents of both sexes aged between 12 and 18 years, enrolled in schools of the state and private in the city of Natal / RN. The selection of schools and participants of the study was randomly through a lottery system. The spirometric evaluation was performed through the digital spirometer One Flow FVC prior to the assessment of respiratory muscle strength. The MICs were measured with MVD digital manometer 300. Statistical analysis was performed using the SPSS 17.0 software STATISTICS, assigning the significance level of 5%. The normality of data distribution was verified using the Kolmogorov-Smirnov (KS). The descriptive analysis was expressed as mean and standard deviation. We used one-way ANOVA test to verify the difference of the averages of MRPs between age and gender and comparing the averages of MRPs between levels of physical activity. The test t'Student unpaired compared the averages of MRPs being ages and sexes. The comparison of mean values obtained in this study PRM with the values predicted using the equations mentioned above was relizada by testing paired t'Student. To verify the correlation between the PRM and the independent variables (age, weight, height) was used Pearson correlation test. Levene's test evaluated the homogeneity of variance. To obtain predictive equations analysis was used stepwise multiple linear regression. Results: There was no significant difference in mean age between the PRM. The male adolescents, regardless of age, showed superiority in MRP values when compared to the opposite sex. Weight, height and sex correlated with the PRM. Regression analysis suggested in this study, pointed out that the weight and sex had an influence in MIP and MEP only in relation to sex influenced. The mean for each PRM adolescents classified as very active were superior to those observed in adolescents classified as irregularly active. Conclusion: This study provides reference values and two models of predictive equations for maximal inspiratory and expiratory pressures, and to establish the lower limits of normality that will serve as an indispensable condition for careful evaluation of respiratory muscle strength in Brazilian adolescents

Associação entre diferentes marcadores antropométricos com variáveis espirométricas e de força muscular respiratória em obesos mórbidos

A obesidade é uma epidemia global em alarmante ascensão. Caracterizada pelo excesso de gordura corporal subcutânea, de caráter multifatorial, está relacionada ao surgimento de diversas co-morbidades, entre elas, várias alterações respiratórias, estas se tornam mais intensas quanto maior o grau de obesidade. Não há consenso na relação entre os marcadores de adiposidade geral ou específicos e suas repercussões sobre a função ventilatória, especialmente em relação à sobrecarga muscular respiratória. Objetivo: Analisar a relação entre marcadores antropométricos e variáveis espirométricas e de força muscular respiratória em indivíduos com obesidade mórbida. Métodos: Estudo transversal entre setembro de 2007 e outubro de 2012. Participaram da pesquisa 163 obesos mórbidos (37.1±9.8 anos e IMC=49.0±5.88 Kg/m2) sem alterações espirométricas. Foram observadas as associações entre Índice de Massa Corporal-IMC, adiposidade localizada (Circunferências de Pescoço-CP, Cintura-CC e Quadril-CQ), percentual de gordura corporal através do Índice de Adiposidade Corporal-IAC, volumes e capacidades pulmonares (CVF, VEF1 e VRE) e pressões respiratória estática (PIM e PEM) e dinâmica (VVM). Resultados: O VRE foi o volume mais afetado pela obesidade (apenas 41%predito) e mostrou associação negativa nas relações com todos os marcadores de adiposidade (IMC: r=-0.52; IAC: r=-0.21; CC: r=-0.44; CP: r=-0.25 e CQ: r=-0.28). Há relação inversa entre o percentual de gordura corporal (IAC) com a CVF (r=-0.59), o VEF1(r=-0.56) e o VVM (r=-0.43). As pressões respiratórias são justificadas principalmente pela adiposidade ao redor do pescoço e o IAC. Nossos dados de força muscular respiratória foram melhores associados aos valores de referências sugeridos pelas equações de Harik-Klan et al (1998) para PIM (R²=0.72) e com a equação proposta por Neder et al (1999) para PEM (R²=0.52). Em um modelo de regressão linear, as variáveis de adiposidade não justificam a VVM, já o VEF1 explica 62% da variância da VVM em obesos mórbidos. Conclusão: O percentual da adiposidade corporal e a circunferência do pescoço estão associados com a força muscular e capacidade de gerar fluxo respiratório de obesos mórbidos. Sugerimos a equação elaborada por Harik-Klan et al (1998) para obtenção de valores preditos de PIM e a equação proposta por Neder et al (1999) para valores de normalidade da PEM em sujeitos com obesidade mórbida. Foi possível fornecer uma equação de referência específica para VVM em obesos mórbidos

A percepção dos docentes da UFRN sobre o programa de apoio a planos de reestruturação e ampliação das universidades federais - REUNI

In recent decades higher education in Brazil has gone through several changes. The Programa de Reestruturação e Expansão das Universidades Federais REUNI has been the greatest overhaul performed by the government in public universities in the last years. REUNI is presented as the biggest reform in tertiary education in contemporary times, having as the main goal a gradual increase in the average rate of conclusion in live learning graduation courses up to 90%, as well as a rate expansion of graduating students in face to face classes per professor. This research aims at studying the perception of professors from UFRN concerning the REUNI program in execution from 2008 until 2012. The study seeks to understand how professors evaluate the program and what the dimensions that most influence in this evaluation are. The study made use of a research tool (survey) which was sent through the internal system of the university, SIGAdmin, to all professors of superior teaching from UFRN. The answers generated by the survey were processed using SPSS statistical software (Statistical Package for Social Science). Factorial Analysis and Multiple Linear Regression were used as an analysis technique. 180 answers were obtained, reaching all UFRN Centers and some academic units, as well as some campuses in the countryside of the state. Through the research was possible to analyze how professors from UFRN perceive the REUNI program implemented in the institution. The results point to the program approval by the professors. Statistical tests showed that the average values obtained in the Centers and academic units are basically the same. It was demonstrated that the extent that most influenced in the answers is linked to practical outcomes of the program, whereas the knowledge of REUNI goals was the least that impacted on the marks given to the program. Another dimension which influenced the perception of professors relates to the influence of REUNI in their activities. It was observed that professors from UFRN don t see REUNI as an impediment to them

Desigualdade regional da mortalidade neonatal no Brasil

In Brazil, despite the decline in infant mortality in recent decades it still has high rates going against recommended by WHO. Being the largest percentage of infant mortality rate composed of neonatal deaths. Objective: A study was conducted to analyze the spatial distribution of neonatal mortality and its correlation with the biological, socioeconomic and maternal and child health care in the Brazilian states in the period from 2006 to 2010. Method: The study made thematic maps and correlation (LISA) for verification of spatial dependence and multiple linear regression models. Results: Was found that there is no spatial autocorrelation for neonatal mortality in the Brazilian states (R = 0.002, p = 0.48). Most of variables were correlated (r> 0.3, p <0.05) with neonatal mortality, forming clusters in the North and Northeast, with the highest rates of teenage mothers, low household income per capita, lower prenatal appointments and beds of Neonatal Intensive Care Unit. The number of Neonatal UCI beds remained independent effect after regression analysis. Conclusion: The study concludes that regional inequalities in living conditions and especially the access to maternal and child health services contribute to the unequal distribution of neonatal mortality in Brazil

Gestão Sustentável da água: um estudo da conscientização ambiental em atividades residenciais urbanas

The search for sustainable solutions through an appropriate environmental administration of the available natural resources, that comes from encounter to the aspirations of preservation of the environment and of the human being, in way to diagnose and to solve the environmental and social problems with the smallest possible impact to the nature and the man, it is the great challenge, so much for that generation, as for the future generations. The study of the environmental problems of the water and the participation and the social actors' environmental understanding as a whole, interferes in the field of the thematic environmental international, contemplating the strategic need of an appropriate administration of that very natural one, through a program returned to the diagnosis of the problems and in the search of compatible maintainable solutions, in a social and environmental politics of planning and environmental education, centered above all in the citizen's voice , user of that system. The present thesis she seeks to study the problem of the maintainable administration of the water, focusing the participation and the citizen's environmental understanding in the use of that very natural one for urban residential activities, in what concerns the approach and analyses of variables that treat of the measurement of general knowledge and you adapt, sense of community of the access to the means of information and of the attitudes and environmental behaviors, besides the variables of partner-demographic characterization or personal identification of the interviewed ones of an exploratory research of the type " survey ", accomplished through a stratified aleatory sampling, being the strata each one of the 4 (four) Political-Administrative Areas of the Natal city, having happened the collection of the data in the period of february to april/2002. The methodology used in this work it constitutes in the application of questionnaires with scales of the type Likert to measure the echo-varied of the study, besides a partner-demographic scale for the characterization of the studied sample. For the analysis of the results, it was made an exploratory descriptive study initially, followed by the use of techniques statistical multivariate s, such as, factorial analysis through the application of main components, besides the accomplishment of studies of multiple lineal regression. To complement this study, the accomplishment of Tests of Independence was proceeded through the Qui-square of Pearson, in way to verify the dependence of the associations between the partner-demographic variables and the principal selected variables and presents in the resulting factors of the factorial analysis. The results appear for a low level of environmental knowledge, of access to the information and community's sense, besides the verification that the principal factors resultants send for the need of feeling emphasis in the programs and administration actions addressed for the environmental understanding, the behaviors and attitudes that approach the information and the environmental education, besides the reuse of the water

Avaliação da pressão inspiratória nasal sniff na população obesa

Introdução: a avaliação da pressão inspiratória nasal (SNIP) é considerada uma manobra complementar da Pressão Inspiratória Máxima estática (PImax) em várias condições clínicas, porém não há relatos na obesidade. Por outro lado, a obesidade tem um importante impacto nos músculos respiratórios especialmente com maiores gordura abdominal o que provavelmente pode ser detectado na avaliação da SNIP que mensura mais precisamente a pressão diafragmática. Objetivo: analisar em obesos a relação entre SNIP e variáveis respiratórias e marcadores de adiposidade. Material e Método: num estudo transversal um total de 92 obesos (38.3±10.2 anos) sem história de doença respiratória ou cardíaca diagnosticada. Foram avaliados na espirometria (capacidade vital forçada-CVF; volume expiratório forçado no primeiro segundo-VEF1; volume de reserva expiratório-VRE) e pressões respiratórias estática (PImax, PEmax e SNIP) e dinâmica (ventilação voluntária máxima-VVM). Sendo considerados os marcadores de adiposidade: índice de adiposidade corporal-IAC; índice de massa corporal-IMC e circunferências do quadril (CQ), cintura (CC) e pescoço (CP). Resultados: 65 obesos mórbidos (IMC=50.8±8.1Kg/m2) e 27 obesos não mórbidos (IMC=35.6±2.7Kg/m2) foram homogêneos (p>0.05) na SNIP (99.1±24.5cmH2O, 87% do predito) e PImax (107.3±26.4cmH2O, 109% do predito). Existe correlação (r=0.5) entre SNIP e PImax somente no grupo de obesos mórbidos. De acordo com as correlações houve associação entre variáveis respiratórias (CVF r=0.48; VEF1 r=0.54; e VVM r=0.54), valores antropométricos (idade r=-0.44) e SNIP somente para os obesos mórbidos. Esses achados foram certificados quando também comparados a quantidade de gordura ao redor do pescoço (CP≥43cm). O modelo de regressão linear stepwise mostrou que a VVM parece ser o melhor preditor para explicar a SNIP nos obesos mórbidos. Nestes obesos a SNIP foi levemente mais baixa (87%predito) que os valores esperados para indivíduos brasileiros saudáveis. Conclusão: em obesos mórbidos a SNIP é moderadamente relacionada a PImax. A SNIP parece ser mais relacionada a VVM que à marcadores de adiposidade.

Relação entre função sexual, sintomatologia depressiva e qualidade de vida em mulheres grávidas

INTRODUCTION: Human sexuality is recognized as one of the pillars of quality of life. In women, sexual function is influenced throughout life by many factors that can lead to the appearance of changes in the cycle of sexual response, and hence the quality of life (QOL). Pregnancy is a period of change, leaving them physically and mentally vulnerable, which may affect sexual function and quality of life during pregnancy. OBJECTIVE: To investigate the relationship between sexual function, presence of depressive symptoms and quality of life in pregnant women. METHODS: The study included 207 pregnant women attending prenatal examination of the Maternity Divine Love, Parnamirim / RN and the participants of the Course for Pregnant Women of the Department of Physical Therapy at UFRN (central campus). Initially it was applied, a questionnaire containing questions about sociodemographic, gynecological and obstetric data, as well as body and sexual self-knowledge. Sexual function was assessed using the Sexual Function Index Female (Female Sexual Function Index - FSFI). To assess the quality of life, we used the Quality Index Ferrans Life & Powers mom. The presence of depressive symptoms was verified by applying the Beck Depression Inventory. The Shapiro-Wilk test for normality was carried variables, Mann-Whitney test for carrying out the comparisons and the Wilcoxon test for comparing the monthly sexual frequency before and during pregnancy. Multiple linear regression was used to verify the relationship between sexual function, depressive symptoms and quality of life. We used the Spearman correlation to check correlation between the variables. Ap value <0.05 was adopted. RESULTS: Sexual function and depressive symptoms were related quality of life (R2 = 0.30, p <0.001). Depression had a moderate negative correlation with quality of life (0.53; p <0.001), whereas sexual function showed a positive correlation with low quality of life (0.22; p = 0.001). The planning of pregnancy, education and income shown to influence depression scores. With respect to sexual function, it was seen that during pregnancy, a reduction in the monthly frequency of sexual partner (Z = -10.56; p <0.001). Among the sexual domain, just the pain, showed a statistically significant difference compared between the second and third quarter (Z = -1.91, p <0.05). The score of the quality of life of women with sexual dysfunction was xvii significantly lower than that pregnant women without dysfunction (Z = -2.87, p = 0.004). Conclusion: Sexual function and the presence of depressive symptoms are related to the quality of life of pregnant women.

Prevalência e fatores associados à alteração vocal em idosos institucionalizados com capacidade cognitiva preservada

Voice disorders (VD) in the elderly can interfere negatively in communication, emotional well-being and quality of life, conditions that correspond to greater exposure to illness and social isolation bringing consequent economic impact for the health system. It is assumed that institutionalized confinement, weakness and morbidity associated to nursing home (NH) contribute to transform VD an especially prevalent condition in institutionalized elderly, including those without cognitive impairment. Thus, the aim of this study was to determine the prevalence and associated factors of VD in NH elderly residents without cognitive impairment. There is no epidemiological diagnostic instruments of VD for elderly populations, so the first step of this study was dedicated to prepare and analyze the psychometric properties of a short, inexpensive and easy to use questionnaire named Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos—RAVI). The methodological procedures of this step followed the guidelines of the Standards for Educational and Psychological Testing and contemplated validity evidence based on test content, based on response processes, based on internal structure and based on relations with other variables, as well as reliability analysis and clinical consistency. The result of the validation process showed that the RAVI final score generate valid and reliable interpretations for the epidemiological diagnosis of VD in the elderly, which endorsed the use of the questionnaire in the second stage of the study, performed in ten NH located in the city of Natal, Rio Grande do Norte. At this stage, data from socioeconomic and demographic variables, lifestyle, general health conditions and characterization of the institution were collected. It was performed a bivariate analysis and it was calculated the prevalence ratio as a magnitude association measure, with a confidence interval of 95%. The variables with p-value less than 0.20 were included in the multiple logistic regression model that followed the Forward selection method. The odds ratio found in the multivariate model was converted into prevalence ratio and the level of significance was 5%. The sample consisted of 117 subjects with predominance of females and average of 79.68 (± 7.92) years old. The prevalence of VD was 39.3% (95% CI: 30.4-48.1%). The multivariate model showed statistically significant association between VD and depressive symptoms, smoking for a year or more and selfreported hearing loss. In conclusion, VD is a prevalent health condition in NH elderly residents without cognitive impairment and is associated with factors involving psychosocial, lifestyle and communicative disability that require attention of managers and professionals involved with NH environment. Strategies to encourage communication and social integration, actions to combat smoking and minimizing the effects of hearing loss could stimulate the physical well-being, emotional and mental health of institutionalized elderly population, contributing to the vocal and communicative maintenance, a more effective social inclusion and better overall health condition.