Saúde bucal de idosos institucionalizados no Brasil

O propósito dessa investigação foi o de estudar as situações objetivas e de auto-percepção em saúde bucal de idosos residentes em Instituições de Longa Permanência de Idosos (ILPIS) distribuídos em 11 municípios pertencentes as 5 regiões geográficas do Brasil. Metodologia: Trata-se de estudo seccional através de um censo com idosos institucionalizados no Brasil. Foram avaliados 1192 indivíduos, residentes em 36 Instituições de Longa Permanência de Idosos (ILPIS), distribuídas em 11 municípios. Deste universo, 587 (49,2%) responderam ao GOHAI. Foi aplicado questionário com questões subjetivas e sobre o comportamento em saúde bucal, além de levantamento epidemiológico seguindo critérios da Organização Mundial da Saúde (OMS). Foram realizados os testes de Mann-Whitney, Kruskal-Wallis, Exato de Fisher, Qui-quadrado e Regressão logística múltipla. Resultados: A idade média foi de 74,98 (+ 9,5). Destes, 51,4% (302) eram do sexo masculino e 152 (25,9) apresentavam alguma dependência. A média do CPOD foi de 28,8 (+ 5,5) e 54,5% (320) dos idosos eram edêntulos. Constatouse que 54,2% (318) e 74,1% (435) não usam nenhum tipo de prótese superior e inferior, respectivamente. O CPI e PIP mostraram que 64,4% (378) apresentaram todos os sextantes excluídos. O GOHAI mostrou que 75% (440) dos indivíduos apresentava auto-percepção positiva em saúde bucal. As variáveis última visita ao dentista (RP ajust=4,058; IC=1,526-10,789), presença de problemas gengivais (RP ajust=5,703; IC=1,754-18,544) e opinião sobre os dentes, as gengivas ou prótese (RP ajust=19,514; IC=5,075-75,041) permaneceram significativas no modelo após regressão logística múltipla. Conclusões: Observou-se predomínio da auto-percepção positiva em saúde bucal em detrimento das precárias condições bucais. Assim, para a população institucionalizada, o presente estudo recomenda a aplicação de levantamentos epidemiológicos e de auto-percepção para assegurar adequado planejamento nas ações de saúde bucal

Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Desenpenho funcional, carga alostática e biomarcadores do estresse em idosos residentes na comunidade

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Violência institucional no âmbito da saúde reprodutiva : a percepção de mulheres usuárias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Cuidado formal em saúde bucal: percepção de senescentes

Ações promotoras de saúde e independência para pessoas idosas são indispensáveis. Compreender essa construção no cotidiano da provisão dos cuidados talvez estimule o desenvolvimento de capacitações ao bem estar nesta população. O objetivo deste estudo foi Identificar a repercussão da provisão do cuidado formal em saúde bucal na percepção de senescentes. Desenvolvemos uma pesquisa de base qualitativa com abordagem fenomenológica, onde realizamos entrevistas semiestruturadas e individuais com 30 pessoas de idade superior a 50 anos (22 mulheres e 08 homens), em um Centro de Convivência na cidade de Natal/Rio Grande do Norte, no nordeste do Brasil. Os relatos obtidos foram analisados em cinco estágios: transcrição dos discursos sem preocupação interpretativa; limpeza de erros linguísticos e repetições; leitura repetitiva e exaustiva para apreensão do sentido das informações coletadas; seleção das unidades significativas dos discursos, correspondendo aos trechos relevantes no horizonte do fenômeno em estudo; e compreensão da ideografia elaborada pelos participantes por grupos temáticos simbólicos. Assim, identificamos as essências temáticas de: determinante social e iniquidade em saúde bucal; e provisão de cuidados de saúde bucal e mal-estar físico, mental e social. Concluímos que a prestação de cuidados agregando abordagem humanístico-ética pode levar a vivências dignificantes no processo de envelhecimento, destacadamente quando estimula a promoção da segurança pessoal. O âmago desse trabalho descortina uma vertente multidisciplinar que perpassa a saúde, a educação e a ética

Percepção e realidade da política de atenção à saúde do idoso nas equipes de profissionais do programa de saúde da família do estado da Paraíba

Investigar os fatores relacionados á percepção que os profissionais das equipes do Programa de Saúde da Família (PSF) possuem frente à realidade da política de atenção à saúde do idoso nas Unidades Básicas de Saúde dos municípios litorâneos do Estado da Paraíba. Trata-se de um estudo observacional descritivo com uma amostra constituída por 120 profissionais de saúde de três categorias distintas (enfermeiro, médico e odontólogo), sendo 104 respondentes como profissionais e 16 respondentes como coordenadores de equipes. A coleta de dados foi realizada através de um questionário auto-aplicável de avaliação fechada e de questões de múltiplas escolhas. Os dados foram processados e armazenados no Programa Estatístico SPSS versão 15.0 e analisados à luz da estatística descritiva. Os resultados indicaram que os profissionais tiveram dificuldade em perceber a realidade da política integral e integrada de saúde do idoso junto aos serviços de saúde em que atuam. O estudo revelou ainda a necessidade de uma definição de estratégias para qualificação dos profissionais garantindo à atenção integral à saúde do idoso sob uma nova visão de atuação

Cartografia da percepção de mês e profissionais sobre a atenção a saúde de crianças/adolescentes soropositivos no município de Natal

This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental de gerenciamento de resíduos sólidos de serviços de saúde, dos servidores do Hospital Universitário Onofre Lopes do Rio Grande do Norte

This research has aimed at studying the perception of University Hospital Onofre Lopes (HUOL) s workers on the environmental management plan of RSSS. They have been interviewed 250 workers: doctors, nurses, nursing assistants, and cleaners. It was used an exploratory and descriptive research of the type Survey, which aims at obtaining of data or information on characteristics, actions or opinions of any group of people. The questions of the questionnaire were of the kind objective", formulated in a model "scale", analyzed in according to the positioning of the interviewee. The wastes of health service have high potential for environmental impact in the activities from HUOL. Actions or environmental protective policy can improve the image of HUOL. They have been detected divergences on the rigor in application of law of ANVISA. The HUOL s workers unaware of the law of ANVISA and they have little or no knowledge about the practices of environmental control, public health and, they do not know the Environmental Management System ISO 14001. They have divergent views on the degree of importance of ISO 14001. There is not a Waste Management Plan for Health Service and / or is not disclosed for most of HUOL workers. It has not carried out audits or defined the goals and objectives. Besides, it has not been identified legal requirements, and there has not been communication about the service is performed or has been made a critical analysis and no control of documents the environmental management plan. The HUOL have not had a committee of environmental management. The direction of HUOL has not been organized courses, training and recycling of waste on environmental control of the health service. On a scale from 01 to 05, the level of aware level concerning to the waste management from health services of the workers, so is at the threshold between 01 and 02. For the reversal of this situation, the first and urgent step is the creation and institutionalization the environmental management committee of the University Hospital Onofre Lopes

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental em laboratórios de análises clínicas

This objective of this work was to investigate the enviromental perception of technician of clinical laboratories, in the city of the Natal/RN, focusing the generated environmental aspects and impacts in the activities, the strategical importance of the environmental management for the activity, as well as the knowledge about environmental norms and resolutions applied to the sector. A type survey exploratory and descriptive was carried through, using a questionnaire applied in 82 clinical laboratory, getting a return tax of 53,65%, or either, 44 laboratories. The results of the descriptive analyses point with respect to environmental conscience of the interviewed, therefore the majority (75%) described the activities of clinical analyses as great imapact on the environment. Although the interviewed present certain knowledge on the advantages of practical of envivonmental protection and the risks that the activities of clinical analyses offer, some important practical of environmental protection arer not develped by the majority of the iterviewed. The carried through statistical analyses had allowed to investigate the level of environmental knowledge of the professionals of the sector, being consisted themselves that they present little knowledge on practical ISO 14001 and of environmental protection in the health public sector. It can be conclude that, a program of environmental qualification for the sector becomes necessary, in order to improve the knowledge of the professionals of the area, and that the majority of the professionals would have a good recptivity therefore recognize the benefits of the practicadl of environmental protection for the competitiveness of the clinical analyses laboratories

Percepção dos idosos sobre saúde bucal

The assessment of oral health status in elderly patients is essential for the development of specific health policies. The prevalence of oral diseases is high in this population. The self-perception of oral health conditions influences the demand for oral care and quality of life for seniors. The aim of this study was to assess self-perception of oral health status in 100 elderly of both sexes, aged 60 years or older and functionally independent the Basic Health Unit of Felipe Camarão II, Natal, Brazil. For comparison of self-perception data was collected in Bom Pastor, Natal / RN. In this research data were collected a questionnaire grouped into two parts. The first part with the socio-demographic data, subjective and objective condition of oral health and access to the service, the second part GOHAI Index. This index consists of 12 items that make it possible to obtain information involving aspects of chewing, speech, phonation, and self-assessed oral health. The results were subjected to statistical tests of Mann-Whitney and Kruskal-Wallis test (α = 0.05), to identify possible predictors of self-evaluation. As a result, 69% were female, ages ranged from 60 to 86 years, with a median of 65 years. In relation to marital status 48% were married. For the years of study, the sample had an average of 3 years. For the last visit to the dentist, only 27% of seniors had visited the Dentist for less than a year. Regarding the questions about the presence of gingival and dental problems were answered by 46% and 21% respectively. The data on the perception of your teeth and gums, 44%. The index showed GOHAI value for self-perception of 30 points to Felipe Camarão and 28 points for the Bom Pastor, both considered a low perception. We identified predictors of self-rated number of people in the room, participate in any associational activity, there is problems with your teeth and your gums. Concluded a negative self-perception of oral health condition by Gone in both areas, influenced by socioeconomic and cultural issues, although they realize the importance given to oral health, but by the misfortunes of other prominent favored little valuing of oral health

PET-saúde na percepção de estudantes: contribuições para a formação na área de saúde

This dissertation aimed to analyze the perception of students about (EPW Health) Education Program at Work for Health Training in the area of Health. It discusses the proposed theme from the perception of students graduating from the EPW- Health courses participants (dentistry, medicine, physiotherapy, nursing, nutrition, physical education) who have developed their school activities in family health units in the city of João Pessoa between 2009/2011.The program aims policies curricular changes as a potential route of contributions to training in healthcare. Attention is drawn to the new possibilities of working health training contextualized, ethically grounded, socially endorsed. It is pointed out in this process the need to adapt to the demands of professional profiles of SUS (Sistema Único de Saúde). This is an exploratory, descriptive study within a qualitative approach, conducted in the city of João Pessoa in the context of health care courses at the Federal University of Paraiba. The empirical material of this study was treated by the use of technical analysis "Categorical Content Theme" by Bardin. The results indicate prospects for promoting new practices and curricular changes, which highlights the EPW- Health, which has been presenting important experiences in teaching -community -service- with the inclusion of students in the municipal health network. We conclude that the path from collection to data analysis, corroborated with the literature to reaffirm the importance and urgency of change in educational processes with a view to greater proximity to the health needs and the SUS. The EPW- Health project is incipient and requires further investigation in terms of effective interdisciplinary and multidisciplinary character of its proposal

Percepção de cuidadores de crianças acerca da prevenção de acidentes domésticos infantis: análise à luz do modelo de crenças em saúde

This study aimed to analyze the perception of home caregivers of children from zero to five years-old on child domestic accidents and their influence in preventing these events. Exploratory and descriptive study with a qualitative approach, conducted with 20 caregivers attended at the Family Health Unit of Cidade Nova in Natal/Rio Grande do Norte, Brazil. The participants should have age less than 18 years-old, being a caregiver of at least a five year-old child and living in the area ascribed of Family Health Unit in the neighborhood Cidade Nova. Data collection occurred between March and April 2013 and a semistructured interview script was used. This stage was preceded by the acquiescence of the director of health institution where the research was developed, the Health Department of the Municipality of Natal as well as the Ethics Committee in Research of Universidade Federal do Rio Grande do Norte under Opinion nº 219 872 and CAAE nº 12236013.7.0000.5537. It is noted that respondents were asked to formal authorization by the Term of Consent. The data were treated according to the technique of the Collective Subject Discourse and analyzed based on three dimensions of the Health Belief Model, relating to perceptions of susceptibility to infant domestic accidents, self-efficacy to prevent infant and indicia domestic accidents for action of preventing domestic accidents in childhood. The results revealed that all the respondents were women, who, in their majority, they are mothers of the children they care, and predominantly they are aged between 18 and 30 years-old, full high school education and unemployed. Concerning the perception of susceptibility, it was unveiled understanding of deponents on various types of accidents, which are considered preventable. For this purpose, it was highlighted that the constant surveillance of the children is essential, keeping in view their high degree of curiosity and immaturity. On the perceived selfefficacy, the participants reported adopting preventive measures; however, they reported experiencing falls, burns, electric shocks and dog bites. In regard to the meaning attributed to experienced accidents they highlighted their feelings of guilt and despair, particularly about the cases understood as serious. Regarding the last dimension analyzed, related to indications for action, family, friends and television were the main source of information about household accidents and their prevention methods; however, health professionals were rarely cited as issuers of such knowledge. It is concluded that there is a widespread perception of women about prevention of domestic accidents and the weakness in the view of health professionals, including nurses, as disseminators of this information. This suggests the need to strengthen the dialogue on the issue and encouraging the participation of caregivers actively in the prevention of child domestic accidents

Percepção da equipe de saúde, discentes e usuários sobre a comunicação com indivíduos surdos na atenção primária

The study aimed to identify in the professionals and students of health courses that work in a health Basic Unit in the city of Natal/RN their perceptions of the care of deaf patients, and with the population's needs with hearing loss in relation to health care. This is a cross-sectional, exploratory, descriptive study, conducted between April to July 2014, with a population composed of 21 health professionals, 17 students and 8 deaf users. For data collection, we used a structured questionnaire with open and closed questions applied to groups composed of health professionals (doctors, dentists, nurses and health workers) and students of medical schools, nursing, physical education, nutrition and social service. The professionals/students answered a semi-structured questionnaire with open and closed questions concerning the possible difficulties the care of the deaf and hearing impaired. Data collection with deaf users was conducted through filmed interview for the Brazilian Sign Language (Libras) could be interpreted as to the Portuguese by the researcher. With the latter it was conducted a survey of their reactions when looking for a care in the health service. Regarding the profile of identification of the subjects, it was analyzed by simple descriptive statistics (absolute and relative frequencies). The open questions were analyzed through the content analysis technique which allowed the categorization process preserving all the points raised in the discussion so that the lines were representative of the whole. When asked about the professionals and students attitude used to communicate with deaf patients possible the following categories emerged: the "writing", the "gestures" and the "third party assistance". With regard of the deaf, when asked about their experiences in seeking care in health, the elucidated categories were: "quality of care to the hearing impaired", "communication with the hearing impaired adequacy" and "dependence on third parties." The closed questions were measured and adapted to the 5 degrees of variation Likert Scale, which comprised three of these issues: degree of difficulty in communication to meet a patient with hearing loss (minimum to great difficulty); feeling of comfort while using sign language (minimum to severe discomfort); and knowledge of the Law 10.436, which provides for the Brazilian Sign Language (Libras) (low knowledge to entirely clear). The data collected with professionals and students revealed some misunderstanding and discomfort in health care for deaf patients, reality also evidenced in the opinion of the deaf participants. This study revealed problems in communication, resulting in negative consequences in serving this population. This diagnosis may be relevant to public policy development and curriculum guidelines essential to the training of health professionals, inclusion and improving assistance to deaf.

Aspectos sociais e de saúde de portadores da coinfecção hiv/tuberculose

Objetivou-se avaliar os aspectos sociais e de saúde e a percepção diante do diagnóstico de indivíduos com a coinfecção HIV/tuberculose. Estudo descritivo, com abordagem quantiqualitativa, realizado em hospital de referência em Fortaleza, Ceará, de janeiro a abril de 2009, utilizando-se entrevista semiestruturada em ambiente privativo. Os dados foram analisados de modo descritivo e por análise de conteúdo. Participaram 16 pacientes com coinfecção HIV/tuberculose, 56,25% do sexo masculino, com faixa etária predominante entre 31 a 39 anos (43,75%), com pouca escolaridade e renda familiar mensal de aproximadamente um salário mínimo. A forma predominante da apresentação da tuberculose foi a pulmonar (62,50%). A percepção sobre a descoberta da coinfecção foi demonstrada por duas categorias: Medo e angústia face ao diagnóstico e Mudanças nos hábitos de saúde e no estilo de vida. Urge, diante dos achados, a promoção do bem-estar psicológico e físico desses pacientes, por meio de ações políticas e de saúde

A ouvidoria pública como instrumento de controle das ações da Secretaria de Saúde do Pará

The State and Public Administration have gone through several reforms in search of a quick operation and the provision of services with quality. With the democratization of the country and the issue of the Constitution in 1988, further reform of the State and Public Administration, joined the government agenda in 1995 and included among its objectives, the principles of participation and social control. In view of this, it raises the Public Ombudsman in order to be a channel for the participation of users in the management of public affairs, social control, transparency of administrative actions, improving the quality of service and meeting the needs of the community. The aim of this study is to assess whether the Ombudsman of the State Department of Public Health to contribute to the period 2006-2008, for the improvement of specialized consulting services. The research is characterized as descriptive, qualitative approach. The collection technique used was the interview, conducted with 37 service users and two servants of the Ombudsman. The analysis was developed based on the perception of users and servers in the opinion of the Ombudsman. The most relevant results of the research showed that 41% of users search the Ombudsman because they believed that solve the problem presented. However, even with this level of public acceptance, the Ombudsman reached average index of resolvability of 53% in the period. In his role has not developed mechanisms for quality control of services, which is mentioned by 67% of users. It turned out the same fact in relation to popular participation, which is confirmed by 84% of users. For 24% of users, the problems raised were resolved, and of these, 56% believe that the Ombudsman has contributed to the positive outcome. As a result of the search results, it appears that the Ombudsman's SESPA / PA, is not fulfilling its role to ensuring the democratization of articipation in management, social control and has limited contribution to solving the problems of users and to improve the quality of services