Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários de prótese parcial removível com arco dental curto inferior

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis

Prevalência da disfunção temporomandibular em estudantes de odontologia por meio de diferentes índices

The epidemiology of temporomandibular disorders varies widely in the literature. The aim of this study was to determine the prevalence of TMD in dental students of the Federal University of Rio Grande do Norte assessed by different indexes. The sample consisted of 101 individuals selected by a randomized process, whose general outline was systematic sampling. For evaluation of the signs and symptoms of TMD, an anamnestic index, Fonseca s protocol, and two clinical indexes, the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders), or standard index, and the Helkimo s Clinical Dysfunction Index were applied. Data were analyzed using the chi-square test and kappa, besides verifying the sensitivity and specificity (5% significance). The diagnosis of TMD by different indexes showed a variation in the prevalence between 72.3% (Helkimo s Clinical index), 64.4% (Fonseca s anamnestic index) and 35.6% (RDC/TMD). There was no statistical difference between the sexes for the RDC/TMD, although this difference was found for Fonseca s and Helkimo s indexes (p<0.05). The most frequent type of TMD were joint disorders (Groups II and III), and the subtypes disc displacement with reduction (17.8%) and arthralgia (15.8%). Most individuals showed a mild TMD (45.5%) for both indexes, Fonseca and Helkimo. When comparing the types of diagnoses, RDC/TMD with Fonseca and Helkimo, low agreement was found (k=0.17 and k= 0.35, respectively). A moderate correlation between the severity of TMD was obtained (kw= 0.53) for Fonseca s protocol and Helkimo s index. High sensitivity and low specificity were seen for both diagnoses compared to standard, resulting in excessive false positives. Within the limitations of the study, it was concluded that the prevalence of TMD can vary widely, depending on the index used for its diagnosis

Associação da depressão e distúrbio do sono em pacientes com e sem disfunção temporomandibular

Objective: To evaluate the inter-relationship between TMD (temporomandibular disorder), depression and sleep disorder. Methods: This is a case-control study with questionnaires in 111 patients, allocated from the Dentistry Department of UFRN, Natal, Brazil, from September 2014 to June 2015, for evaluation of depressive symptoms through the BDI (Beck Depression Inventory); sleep disorder, the PSQI (Pittsburgh Sleep Quality Index) and DTM through the RDC / TMD (diagnostic criteria to search for DTM). All indexes were applied by a single examiner previously trained and calibrated. The collected data were analyzed with chi-square tests of Pearson (χ2) and the unconditional logistic regression. Results: women had a risk of 2.85 times more likely to develop TMD (p = 0.046). The OR (odds ratio) shows that sleep disturbance increases by 2.19 the chances of having TMD (p = 0.062) and depressive symptoms increase the risk by 3.16 times in developing dysfunction (p = 0.053). Conclusion: The data of this research allows us to conclude that patients with TMD, in this population, were more likely to develop changes in sleep and depressive symptoms.

Análise do estado da arte dos aspectos diagnóticos, periciais e jurisprudenciais das LER/DORT no contexto previdenciário das doenças do trabalho no Brasil

Objetivo: analisar o estado da arte dos aspectos diagnósticos, periciais e jurisprudenciais das LER/DORT (Lesões por Esforços Repetitivos / Distúrbios Osteomusculares Relacionados ao Trabalho) no Brasil. Materiais e Método: trata-se de pesquisa descritiva, de natureza qualitativa, com formato documental, utilizando-se a técnica de análise de conteúdo. A avaliação evolutiva da legislação previdenciária relacionada as LER/DORT foi realizada através da pesquisa no banco de dados disponibilizado pelo Governo Federal e mediante a consulta ao DATAPREV/Sislex. A avaliação dos aspectos diagnósticos foi instrumentalizada através, principalmente, de artigos científicos publicados entre 2003 e 2008, nas línguas portuguesa, inglesa, espanhola e francesa, relacionados com os métodos de diagnósticos complementares das LER-DORT (ressonância magnética, tomografia computadorizada, ultrassonografia e eletroneuromiografia). As jurisprudências foram obtidas através da busca dos julgados sobre o tema, entre 2003 e 2008, pertencentes ao Supremo Tribunal Federal, Superior Tribunal de Justiça, Tribunais Regionais Federais, Tribunal Superior do Trabalho e Tribunais Regionais do Trabalho. Resultados: foram identificados 48 artigos abordando os aspectos diagnósticos das LER-DORT, observando-se que os exames por ressonância magnética, ultrassonografia e eletromiografia demonstraram ser mais efetivos, dentro das suas especificidades, para a complementação do exame clínico de patologias relacionadas às LER-DORT. A análise das 123 jurisprudências selecionadas demonstrou, de forma geral, que as LER-DORT equiparam-se ao acidente de trabalho, devendo apresentar nexo de causalidade (atestado através de laudo médico-pericial) e, ainda, ensejam a ação por danos morais, a qual, devido à EC nº 45 passou a ser competência da Justiça do Trabalho. O Estado da arte dos aspectos periciais encontra-se representado pela vigência da Instrução Normativa n. 98/2003, a qual traz como aspecto fundamental a determinação de novos parâmetros a serem considerados na definição de um quadro de LER-DORT, dispondo, ainda, sobre a conduta ética que deve ser adotada pelo médico perito, bem como chama a atenção para a necessidade dessas doenças do trabalho serem comunicadas às autoridadades competentes, através da emissão da Comunicação de Acidente de Trabalho (CAT). Conclusão: as LER-DORT representam, hoje, um problema de importante impacto, não apenas previdenciário, mas também econômico em diversos países, nos quais o Brasil encontra-se inserido. Estudos sobre o estado da arte relacionados às LER-DORT são fundamentais para auxiliar na construção de um modelo crítico e consciente que colabore com a garantia de sustentabilidade do sistema previdenciário no Brasil

Sistemas de informação geográfica e análise espacial de dados como ferramentas para determinação de agregação espacial de doenças: a hanseníase como modelo

This work demonstrates the importance of using tools used in geographic information systems (GIS) and spatial data analysis (SDA) for the study of infectious diseases. Analysis methods were used to describe more fully the spatial distribution of a particular disease by incorporating the geographical element in the analysis. In Chapter 1, we report the historical evolution of these techniques in the field of human health and use Hansen s disease (leprosy) in Rio Grande do Norte as an example. In Chapter 2, we introduced a few basic theoretical concepts on the methodology and classified the types of spatial data commonly treated. Chapters 3 and 4 defined and demonstrated the use of the two most important techniques for analysis of health data, which are data point processes and data area. We modelled the case distribution of Hansen s disease in the city of Mossoró - RN. In the analysis, we used R scripts and made available routines and analitical procedures developed by the author. This approach can be easily used by researchers in several areas. As practical results, major risk areas in Mossoró leprosy were detected, and its association with the socioeconomic profile of the population at risk was found. Moreover, it is clearly shown that his approach could be of great help to be used continuously in data analysis and processing, allowing the development of new strategies to work might increase the use of such techniques in data analysis in health care

Construção e validação de instrumento simplificado para diagnóstico de disfunção temporomandibular em pacientes adultos

As disfunções temporomandibulares (DTM) representam a maior causa de dor não dentária da região orofacial. Dada sua alta prevalência na população em geral e a existência de inúmeros instrumentos diagnósticos não padronizados, buscou-se elaborar e validar um questionário simples, de acessibilidade ampla e aplicação prática, com vistas a contribuir para o diagnóstico e o estudo epidemiológico das mesmas. A estratégia utilizada na montagem do instrumento foi estabelecida com base na avaliação criteriosa de questionários já existentes na literatura, validação de expertos na área de DTM, validação fatorial, de face (na primeira fase do estudo) e, frente ao padrão ouro (RDC/TMD), na segunda fase do estudo. Na primeira fase, participaram 160 indivíduos. A consistência interna resultou num Coeficiente Alfa de Cronbach de 0,752 para o questionário com sete itens; enquanto que para o questionário com cinco itens, este resultado foi de 0,694, não sendo o mesmo, considerado baixo por avaliar apenas cinco questões e ainda, em razão do tema central da pesquisa ser bastante subjetivo. A análise fatorial confirmatória apontou para uma variância total dos fatores extraídos do questionário com sete itens, de 58,2 % e do questionário com cinco itens de 70,04%. Portanto, o questionário com cinco questões, apresentou resultados estatísticos superiores ao de sete questões. Na validação frente ao padrão ouro (RDC/TMD), foram avaliados 99 indivíduos tendo sido testados os dois questionários, com sete e com cinco questões. Na estrutura com sete questões, ao se categorizar as mesmas por totais de pontos obtidos, em quatro condições, obteve-se o melhor resultado quando se considerou com DTM a faixa entre 10 e 21 pontos, sendo 85,1% positivos também no RDC/TMD, com acurácia de 90,1% e Kappa 0,817. Nesta condição, a sensibilidade encontrada foi de 95% (IC 95%, 91 a 99), especificidade de 87% (IC 95%, 81 a 93), VPP 85%, VPN 96%, LR+ 7,3 e LR- 17,4. Quando os dados foram avaliados para o questionário com cinco questões (QST/DTM), pode-se observar que o melhor ponto de corte foi quando se considerou como portadores de DTM, os indivíduos na faixa entre 7 e 15 pontos, com acurácia de 85,8% e Kappa 0,817. Nesta condição, a sensibilidade foi 88% (IC 95%, 81,6 a 94,4), especificidade 84% (IC 95%, 76,8 a 91,2), VPP 80%, VPN 90,5%, LR+ 5,5 e LR- 7,0. A simplicidade do presente questionário (QST/DTM) com apenas cinco questões, possibilita seu uso como elemento de triagem inicial na área da dor orofacial em disfunção temporomandibular, com boa compreensibilidade, confiabilidade, reprodutibilidade e possibilidade de aplicação em pesquisas epidemiológicas. Concluiu-se que o questionário aqui validado, permite sua aplicação de forma simples tanto por profissionais e pesquisadores da Odontologia como de outras áreas da saúde

Avaliação dos parâmetros hematológicos e imunofenotípicos de pacientes com doenças linfoproliferativas crônicas no Rio Grande do Norte

Chronic lymphoproliferative disorders (DLPC) are lymphoid system diseases characterized by the abnormal proliferation of mature lymphocytes that affect B cells, T lymphocytes and NK cells. The aim of the study was to demonstrate the relevance of immunophenotyping by flow cytometry in patients with prolonged lymphocytosis and / or cytomorphological changes compatible with lymphoproliferative diseases. In this study 460 patients (244 men and 216 women) with DLPC were evaluated. Were analyzed by flow cytometry with a panel of monoclonal antibodies consisting of CD3, CD4, CD5, CD8, CD10, CD19, CD22, CD23, CD25, CD38, CD45, CD16/CD56, and HLADR heavy and light chains of immunoglobulins. It also examines information regarding age, gender of patients and laboratory data as leucocytes, cytomorphological analysis, platelet count and hemoglobin determination. The results showed 398 cases of chronic lymphoproliferative disorders and 62 of DLPC B cell lymphoproliferative diseases T. B showed the following distribution : 253 cases of chronic lymphocytic leukemia (CLL), 42 cases of multiple myeloma ( MM ), 37 cases of lymphoma non - Hodgkin lymphoma in leukemic phase (NHL) , 17 cases of pro- B lymphocytic leukemia ( B -PLL), 15 cases of mantle cell lymphoma (MCL ), 12 cases of plasma cell leukemia ( PCL), 9 cases of lymphoma Burkitt (Linf B), 8 cases of leukemia villous cells ( LCV), 3 cases of splenic lymphoma with villous cells (LECV), a case of follicular lymphoma (LF) and a Waldenströn macroglobulinemia ( MW). The diseases source NK / T were 23 cases of peripheral T cell lymphoma (LCTP), 14 cases of T prolymphocytic leukemia (T -PLL), 10 cases of leukemia T of large granular lymphocytes (LGL -T) 9 cases of leukemia cells of adult T (LCTA), 5 cases of Sezary syndrome (SS) and a case of large granular NK leukemia (LGL -NK) lymphocytes. In conclusion, the combined use of the monoclonal antibody panel careful cytomorphological analysis was shown to be essential in immune diagnosis and classification of chronic lymphoproliferative disorders. This study was approved by the IRB - HUOL under number 356 / 09

Avanços e retrocessos na articulação de um pacto territorial: a experiência do PRONAF Infra-Estrutura

Since minetics The economics and political promotion along the necessity of flexibility in states actions admited actors partipction and social controlo on process of construction in local development. The Programa Nacional de Fortalecimento à Agricultura Familiar (PRONAF) by this framework consists suprass the specific points about contry world in order to embrace territorial dimension of development, focalizing actions that estimulate co-operative pratices among local agents. This work proposal intends to identify advances and regression of PRONAF Infra-estrutura (Framework) by one territorial pact organization considering its administration about mechamisms on advantage conmflicts between distinct actor and their ables to atimulates a construction of new relationships between governors and population. Undderstanding PRONAF action like a process that come from its instrumental proportion surpass looking for substantial elements constructionm on intervention of local development considering administration mechamisms in São Paulo do Potengi (RN) city-council-starting by Conselho Municipal de Desenvolvimento Rural as well changes of institutional arrangement with território da Borborema erection. Throngh documental studies, bibliography researches and interviews we indenttfy an articulante power of Territorial pact partnerships like one of these political process and its sector character as their limits

EJA: saberes na articulação curricular da Escola Municipal Professor Amadeu Araújo

The target of this paper is to investigate the possibilities of inscribing into the EJA curriculum the knowledge detected in the neighborhood of a school if the point of view of the student body regarding the basic schooling deserves its due consideration. The empirical field of our research focuses on the elementary school of professor Amadeu Araújo Municipal School in Natal. Our investigative course tried to understand the way pupils think the curriculum contents of knowledge spread around the school from the vision furnished by their elementary school. With this, we hoped to develop a creative understanding concerning that question. Then we reviewed, along the debate, questions related to Nova Natal Housing Estate and its historic, social and cultural beginnings taking in account the participants memories of this research and their suggestions concerning the utility of the community knowledge to the curriculum practices. This project is supplied by the qualitative research and reinforced by the Focal Group s methodological procedures and semi-structured interviews. This procedure allowed us to discern different points of viewing, feeling and understanding in the complexity of the daily life around school and its environment. With these elements, we could note that some students perceptions pointed to a basic schooling fomented by traditionalized pedagogical practices in which teacher and pupil seldom dialogue with each other, what corroborates the impression of undervaluation of the pupil s role. Consequently, the nets of knowledge waved around the school in Nova Natal Housing Estate become useless, when they could be of great utility if inserted in the curriculum contents

Articulação ensino/serviço na visão de discentes de enfermagem

It is a descriptive study with a qualitative approach aimed at understanding the impact of the teaching / service between the Nursing College of University of Rio Grande do Norte (FAEN / UERN) and health services in the city of Mossoró / RN on student s learning process. Hence, it was inquired to rescue and over-elaborate the trajectories experienced by students who were graduating in the year of 2009 the Nursing graduation course. It was used, as guidance tool a questionary with both open and objective questions to support the data collection. The data analysis was accomplished based on the precepts proposed by Bardin. The research revealed a clear need of bond establishments with the involvement of the students on services as well as professionals inserted on Academy, in a way that knowledge can be built collectively and the difficulties can be eased.

Trânsito de saberes e campo representacional na visão dos profissionais da saúde da família e do programa de educação pelo trabalho e para a saúde

The Family Health Strategy (ESF) is emerging as a possible restructuring of services and new practices of intervention in health care; it requires skilled professionals to work with that framework. Within this purpose, we established the Education Programme for Work and Health (PET-Saúde), in order to integrate teaching and service activities, focusing on primary care. On this basis, the aim of this work is to apprehend the social representation of nurse, doctor and dentist (Project PET-Natal Health RN preceptors) on the ESF, while practice field of them. It is a descriptive and exploratory study, with a qualitative approach, carried out in 07 Family Health Units (USF) included in the PET-Saúde Natal (RN). The population was composed of 35 professional components of the primary care team with bachelor's degree of the USF linked to this project. The sample was composed of 05 nurses, 05 physicians and 05 dentists, for a total of 15 subjects. Data were collected through three instruments: the drawing-themed story, a semi-structured individual interviews and field diary. The data relating to the identification of the subjects were entered and tabulated by the Microsoft Excel software 2007 version. The drawing analysis and interpretation is given by the significance attributed to the resource chart from title and keywords assigned by the subjects, considering the ESF as an inductive term. The stories and interviews were transcribed and typed and then subjected to read/listen the material and a lexical analysis through Alceste. After this process, the discursive material was analyzed and discussed by theoretical and methodological feature of the Social Representations theory. The majority of health professionals were female, aged between 46 and 52 years old, married, income less than six minimum wage, time since graduation ranged from 22 to 29 years and working time in the ESF range from 02 to 11 years. From the classification system ALCESTE were selected categories identified by: Category 1 - ESF: relations and territory; Category 2 - Training and bond profile; Category 3 - Working process in the ESF; Category 4 - Articulation between teaching and service; Category 5 - Health care and disease prevention. The representational field construction, while a process, followed the logic of structural cores in existing categories. In this sense, it is clear that the ESF is an environment rich in diversity, experience and relationships with potential such as the relationship "very subject-subject" and the link established between professional-community, but also has some weaknesses such as poor working conditions, lack of popular participation and management support, thus difficulties in the achievement of teamwork. Being essential to that end, the teaching-service aimed at the formation of a new health professional able to work in the ESF. In this research, the training of the representational field encountered a diversity of structural cores, or thoughts on training, about the ESF because of the greater emphasis on the here and now of the interaction between health professionals, the ESF, the community, PET Health-UFRN and students, emphasizing that such proposals are still considered as concepts in the context of recent health and that, therefore, are not fully realized in the social imaginary

Ações dos agentes comunitários de saúde diante do usuário da estratégia saúde da família com estados depressivos no Município de Abaiara-CE-BR

Brazilian health public assistance is going through two Reforms, Sanitary and Psychiatric, and through these the assistance is guaranteed in the three levels: primary, secondary and tertiary. Thus, mental health assistance should be offered since preventive cares until the ones that demand larger technological apparatus. Programs like Health Community Agent's Program (HCAP) and Family Health Strategy (FHS), besides increasing the services coverage, have been making possible the system reorientation in the meaning of integrality, universalization and equity. Thus, united intervention of mental health team and FHS can offer several benefits to the population, providing assistance and follow-up to patients with mental disorder. It was aimed to assess health community agents facing the user of Family Health Strategy in depressive state. This quanti-qualitative study took place in the municipal district of Abaiara-CE. Semi-structured interview was applied with health community agents and Beck Depression Inventory with the users registered in Family Health Strategy. It was verified that among the 64 users interviewed, 12.5% didn't present symptoms of depression, 10.9% presented symptoms of light depression, 14.1% symptoms of moderate depression and 62.5% symptoms of serious depression. For the 22 health community agents interviewed, they all reported the existence of people with symptoms of depression in their personal micro-areas, being difficult to work with them, once the FHS team is not qualified to work with mental health problems. It was verified that the Municipal district doesn't have specialized professionals, making difficult the routing and treatment. Based on these results, it was concluded that in spite of the articulation of mental health with FHS is necessary and benefactor to the population, it still doesn't exist, worsening the situation, mainly in small Municipal districts, once they don't have mental health services. Thus, the population is exposed and without follow-up, which allows the identification of installed diseases and with gravity, like depression, because there are no prevention and control activities. It is recommended, due the extreme need, the elaboration and implantation of a mental health program in these municipal districts, articulated with FHS

Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

Trajetos no labirinto: história de vida dos portadores de doenças oncológicas em uso de transfusões sanguíneas na cidade de Natal/RN

The studies paths in the maze: life story of individuals with oncological diseases into use of blood transfusion in Natal has the hemotherapy as a primordial procedure to review the relationship between users of oncological health and the due ramifications. The hemotherapy looks for supply the organic needs through blood transfusion, which acquires vital function to the ones that have cancer, because it might reestablish the functionality of the organism throughout the raising of blood components. The impact over the transfusion affects emotionally and physically the users life. Aiming to reflect on these impacts, this study tried, through narratives of lives, rescue their experience since their knowledge of the disease until the time of blood transfusion using. It s about an exploratory-descriptive study, where the qualitative approach uses the theoretical-methodological reference of the oral life history to analyze a colony consisting of five users of health diagnosed with cancer, with achievement of at least three blood transfusions, the clinic Núcleo de Hematologia e Hemoterapia - UFRN, in Natal-RN. The network, in turn, was composed by employees of both sexes, regardless of age, who voluntarily agreed to participate in the study. The data collection, with approval of the Ethics Committee in Research, Liga Norte Riograndense Contra o Cancer, on the number 001/001/2012, occurred through semi-structured interviews, recorded individually in the home context that was previously chosen by employees. The methodological procedure occurred with the transcription of the interviews and their transcreations, and analysis of reports by thematic content analysis. At the reading orientation and interpretation of the employees stories, were discussed three categories of analysis: the impact on psychological REVIEW; impact on socialization and group membership, the environment and the impact of blood transfusion on treatment. Based on the narrative of the life histories of employees, we conclude that the experiences and feelings, hope and sorrow, pain and faith, even when facing a disease like cancer, bring lots of teaching and learning to health professional that deposits humanization health and reinstate hemotherapy forms of clinical critical

Enfermagem na atenção primária em saúde no screening de adolescentes com excesso de peso

One of the Primary Health Care strategies for adolescent health is the growth and development follow-up and the early detection of overweight adolescents. Even though the School Health Program in Brazil proposes to evaluate the nutritional state of the school population in the corresponding community health units, not all cities have adhered to the Program and many nurses do not recognize overweight as a problem in their territory. The objective of the study was to identify the nurse´s participation in the screening of overweight adolescent students in their work territory. Cross sectional study conducted in eight state supported schools of the municipality of Natal/RN and in four Primary Health Units. The total student population was 27.277. A stratified sample was statistically calculated based on the student population of the four city geographical zones: 112 North , 74 West; 108 East; and 78 South, totalizing 372 adolescents. The students were selected by a probability process where eight schools were first selected, two per district, until the number per subsample in each district was reached. Four primary health nurses, responsible for the health units were included. Two instruments were used for data collection, a screening questionnaire and a semi-structured interview form for questioning of the nurses. The content of both instruments was validated. Anthropometric and health data were collected from the students and analyzed with descriptive and analytical statistics. Interview data were transcribed and submitted to content analysis. The nursing diagnosis of overweight was identified in 50 (13,5%) of the adolescents and its association with consumption of foods that have cardiovascular risk (canned foods, pasta and fried food). An association of the nursing diagnosis was identified with family history (diabetes, hypertension, obesity, and kidney disease). The nurses judged that care of overweight adolescents was important but noted difficulties because of the absence of this population in the health units, because of their work overload, and the lack of school articulation. The nurses do not have impacting actions with this population and delegate the responsibility to other professionals. It is concluded that overweight is a nutritional problem relevant to the adolescent school population in Natal/RN, with a 13,5% prevalence and that it is related to food consumption with cardiovascular risk and family health history. The nurses consider overweight as an important public health problem but do not envision ways to maintain linkage with adolescents and with the school to promote the needed care