Adaptação para o português de questionário de avaliação da informação científica em saúde na imprensa (Index of Scientific Quality)

OBJETIVO: Adaptação para a língua portuguesa e avaliação da aplicabilidade do questionário Index of Scientific Quality (ISQ) em textos sobre saúde da mulher, apresentados por revistas brasileiras. MÉTODOS: O estudo é de corte transversal. Foram coletados textos publicados entre agosto de 2005 e julho de 2006 nas principais revistas semanais: Veja, Época e Isto É. O questionário utilizado possui oito itens, que variam de um a cinco, e medem a aplicabilidade, o grau de opinião, a validade e o alcance da descoberta, precisão, coerência e consequência dos dados, além de um item global, que resume os outros itens. O ISQ foi traduzido, retrotraduzido e submetido à prova piloto até a versão definitiva, utilizada por dois médicos e dois jornalistas. Após a análise dos textos, foi verificada a consistência interna dos itens do questionário pelo coeficiente alfa de Cronbach e a concordância inter e intraobservador para cada item por meio do índice Kappa. RESULTADOS: A amostra conteve 80 textos. A consistência interna dos itens variou entre 0,81 e 0,96. A concordância interavaliadores foi de -0,03 a 0,48 e a intraobservador variou entre 0,27 e 0,34. (IC 95%). CONCLUSÃO: Os itens do questionário mensuraram de forma adequada a qualidade científica, porém a baixa concordância inter e intraobservadores indica a necessidade de novos estudos para se avaliar a versão brasileira do ISQ.

Efeitos da reconstrução mamária imediata sobre a qualidade de vida de mulheres mastectomizadas

OBJETIVO: avaliar prospectivamente os efeitos da reconstrução mamária imediata sobre a qualidade de vida de mulheres mastectomizadas. MÉTODOS: foram incluídas 76 mulheres submetidas à mastectomia no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, em Campinas, São Paulo, Brasil, entre Agosto de 2007 a Dezembro de 2008. Dois grupos foram formados, 41 mulheres no grupo de mulheres submetidas à mastectomia associada à reconstrução imediata da mama (M+RI) e 35 no grupo de mulheres submetidas à mastectomia exclusiva (M). A avaliação da qualidade de vida foi feita com o uso do questionário World Health Organization - Quality of Life (WHOQOL-100). O questionário foi aplicado em três momentos: na data da internação, após um mês e novamente seis meses após a cirurgia. Os escores do WHOQOL-100 foram calculados conforme roteiro de análise fornecido pela Organização Mundial de Saúde. Para análise comparativa dos escores entre grupos, foram utilizados os testes t de Student, exato de Fisher, χ2 e Mann-Whitney, quando os dados eram paramétricos. Para análise das medidas repetidas, ao longo do tempo, foi utilizada a ANOVA e ANOVA para medidas repetidas. RESULTADOS: em todos os momentos, desde o pré-operatório, a pontuação média do Grupo M+RI foi maior que o Grupo M, principalmente nos domínios físico, psicológico, nível de independência e relações sociais. Dos seis domínios abrangidos no questionário, em três (físico, relações sociais, meio ambiente) não foram encontradas diferenças significativas. Houve melhor pontuação para o Grupo M+RI (15,5 a 14,9 no M+RI e 14,3 a 14,2 no M; p=0,04) no domínio psicológico. Observou-se redução significativa do nível de independência no primeiro mês pós-operatório em ambos os grupos, com recuperação significativa após seis meses. CONCLUSÕES: os presentes resultados sugerem que a reconstrução mamária imediata é benéfica para aspectos psicológicos da qualidade de vida, sem afetar a funcionalidade física da mulher.

Tradução, adaptação e validação da versão brasileira do questionário utian quality of life (uqol) para avaliação da qualidade de vida no climatério

The present study had as objective translates, to do equivalence and validation of the Utian Quality of Life (UQOL) for the Brazilian population through methods internationally accepted, in which the original questionnaire was translated for the Portuguese by three teachers and the consensual version was translated back for English by two American teachers (back translation). A multidisciplinary committee evaluated all versions and the final version in Portuguese was applied to climacteric women for the process of adaptation. Validation of the instrument was performed by measuring the reliability and validity properties. Construct validity was examined through the comparison between UQOL and the general measuring scale of quality of life Short Form-36 (SF-36). The final version of translation process was easily recognized by the target population, that didn't tell understanding problems. The results obtained for the reliability intra and interobserver showed significant agreement in all of the subjects. The construct validity was obtained through correlations statistically significant among the domains occupational, health and emotional of UQOL with the SF-36 domains. For the exploratory factorial analysis, it was verified that three factors explain 60% of the total variance of the data, the present study allowed concluding that UQOL was appropriately translated and adapted for applicability in Brazil, presenting high reliability and validity. In that way, the executed project provided the involvement of different areas as gynecology, psychology and physiotherapy (interdisciplinary). Thus, this instrument can be included and used in Brazilian studies to assessment the quality of life during the climacteric years

Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

O conhecimento e as atitudes das famílias de pacientes em tratamento em tuberculose na atenção primária à saúde

This study thus sought to examine knowledge about TB and attitudes of patients families in disease treatment in Primary Health Care in Natal- RN. To this end, a cross-sectional study was undertaken through a questionnaire with families of patients diagnosed with TB and follow up by APS from Natal. The study subjects were recruited from a non-probabilistic way, by convenience, contemplating a sample of 50 families. Among the criteria considered for inclusion of subjects, older than 18 years were considered, as well as residing with the TB patient and in Natal and availability to participate in the research. Data collection was performed by own researcher and an assistant, through a questionnaire with families of patients diagnosed with TB following the double independent digitalization of data. In the analytical phase, was initially conducted an exploratory phase and univariate data, with description of the position measurements (mean, median, mode) and dispersion (confidence interval and standard deviation). In bivariate analysis, it was conducted an intersection of dependent variables of knowledge e and changes of attitude dichotomous, with each of the independent variables, using contingency tables and calculating the chi-square test and, when appropriate, the Fisher exact test. In 2x2 tables, calculated the odds ratio (OR) with confidence intervals of 95% (95% CI). From the selected sample, 43 (86%) subjects were female, average age and median respectively of 46.64 and 46.50 years, 25 (50%) had elementary school. The knowledge expressed by family members about TB was considered satisfactory. However, the lack of interest of the family (54%) in seeking information about tuberculosis; the wrong way of reply in relation to the organism causing the disease (64%); the water content (62%) and contaminated food (54% ) as a means of spreading TB was a weakness identified in the investigation. Regarding the time of transmission, 90% of respondents indicated not know or answered wrong. From investigated independent variables, only two were associated with lack of knowledge of TB, and they did not have religion (OR: 0.146, 95% CI: 0.027 to 0.800) and income below 1, 7 minimum wages (OR: 0.155, 95% CI: 0.029 to 0.813). Thus they seem to exercise a protective effect on this outcome. As for the changes in attitude, most of the found variables had no association with statistical significance, except no internet access (OR: 0.212, 95% CI: 0,048-0, 935). Most attitudes were positive in relation to TB patient. Results have demonstrated weaknesses in TB care, which has taken on a more individual and welfare character. Data not only express health outcomes produced by health services, but also the political and social situation of the families that are affected by TB

Horticultura no baixo curso do Rio Doce, zona norte do Natal/RN: avaliação da qualidade da água por meio de ensaios ecotoxicológicos

The research is developed in areas of horticulture in the city of Natal, in the neighborhoods of Lagoa Azul, Pajuçara and Redinha, along the Doce River, border area with Extremoz city, Rio Grande do Norte State. The region of the fluvial plain of Doce River is located in an Environmental Protection Zone (ZPA-9). This is one of the ZPA which is not under the regulatory marks and there are several environmental problems caused by use and land occupation, featuring an evident disregard of environmental laws and whose protection is hindered by the lack of specific legal mechanisms. This study aims to provide an overview of the use of pesticides in the lower course of the Doce River, in Natal, Rio Grande do Norte, and to assess environmental degradation in the area through chronic toxicity tests using the microcrustaceous Ceriodaphnia dubia Richard 1894 (Cladocera, Crustacea) as test organism. Visits were made to the area in 2009 and 2010. To obtain information a diagnosis of the local situation was accomplished based on personal observation and non-participatory photographic record, with the aim of assessing the environmental characteristics, population diversity and work processes of horticulturists. During the visits four different points of the Doce River were chosen to collect water for ecotoxicological tests and survey of physico-chemical parameters (dissolved oxygen, pH, chloride, turbidity, conductivity and temperature), which were measured in the field using Multiparameter Probe (TROLL 9500). The adverse effects of pesticide use in the lower course of the Doce River is a major problem for both the environmental and human health, since many of the substances and active principles that enter in the composition of the products are synthesized molecules whose effects can only be evaluated through different studies on their actions and behavior at short, medium or long term

A saúde bucal do idoso brasileiro: revisão sistemática sobre o quadro epidemiológico e acesso aos serviços de saúde bucal

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

(Em defesa dos) Cuidados Paliativos na Atenção Primária à Saúde

One of the basic principles of the Brazilian Public Health System (SUS) is integral assistance, which considers the integrality of the individual, of service and care, which should necessarily include end of life care. Our aim was to analyze the work process of health professionals at the Family Health Strategy / Primary Care that already cared for people in the dying process to propose viable contributions to the Public Health area as regards the implementation of Palliative Care in Primary Care. We present data referring to the following themes: Singular Therapeutic Project (PTS); death quality as PTS goal (work purpose); the team's ways of doing (bonding as a pact condition). Eleven health professionals (four nurses and seven physicians) linked to the Family Health Strategy (ESF) of Campinas (São Paulo) participated on this research. From the interviews, data analysis followed the Socio-Historical Psychology theoretical and methodological approach. The professionals' activity was analyzed in articulation with the specificities of caring for people in the dying process. We found that action planning in health is oriented by the Singular Therapeutic Project (PTS), with an emphasis in social diagnosis and the need of a bond for attaining a pact. It is understood that the purpose of health professionals' activity is to promote dignity and life quality in the dying process, but integral care should include not only individual and family care, but also the defence of full human development during all phases of life.

Osteoartrose em joelhos como fator limitante para a qualidade de vida em idosos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da qualidade dos serviços hospitalares com a adaptação do modelo SERVQUAL em dois hospitais de Bauru - SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Compreender o trabalho na Atenção Primária à Saúde para desenvolver ações em Saúde do Trabalhador: o caso de um município de médio porte

INTRODUCTION: Attention in Worker's Health (WH) integrality incites expansion of Primary Health Care (PHC) actions. So, it is necessary to understand the work carried out at PHC units and its possibilities to subside WH plans and procedures aiming at workers' health integral attention. OBJECTIVE: To present PHC workers' perception concerning WH actions performed in health care units of a mediumsized municipality in the state of São Paulo. METHODOLOGY: data collected through a 20 question-self-assessment questionnaire prepared by the researcher, using descriptive analysis of closed questions and content analysis of open questions. RESULTS: 45% of all workers answered the questionnaire. All health units in the municipality and all the professional categories part of the PHC teams were enclosed. The answers indicated that the PHC personnel, when providing assistance to users, take their jobs into consideration, and that some actions concerning worker's health are carried out at health care units. The respondents also pointed out that their difficulties to perform these actions are much more related to aspects of the system organization and management, than to the particularities of the worker's health area. CONCLUSION: The study indicates that health care worker's working condition is an important issue for the implementation of PHC worker's health actions

O trabalho como estratégia de atenção em saúde mental: cartografias do conceito Trabalho nas políticas públicas de saúde

Pós-graduação em Psicologia - FCLAS

O trabalho do enfermeiro na vigilância à saúde da criança sob o olhar da gestão da Atenção Básica à Saúde

This study aimed at apprehending and analyzing the perspective of Primary Health Care managers concerning nurses’ work in Children’s Health Surveillance in a city in São Paulo state. The study population consisted of eight professionals from different professional categories with direct activity in the city’s management of the population’s Health Surveillance. It is a descriptive, qualitative study. Data were collected by means of recorded semi-structured interviews. The framework used for data analysis was the thematic Content Analysis Method. The results were systematized into three themes: 1- Managers’ conceptualizations concerning Children’s Health Surveillance and its application in practice; 2- Managers’ perspectives concerning nurses’ work in Children’s Health Surveillance; 3- Qualification of Children’s Health Surveillance under the view of the municipal management. The conceptualizations concerning Children’s Health Surveillance that were apprehended showed to be convergent as they indicated this model’s appropriateness to identify and prioritize children’s care in vulnerability conditions in the territory where they live. However, some managers did not include, in their statements, health promotion aspects as one of the cornerstones of their managerial action. Nurses were considered to be fundamental in the Children’s Health Surveillance process due to their competencies and responsibilities undertaken in this health provision level. The main difficulties for adequate implementation of Children’s Health Surveillance in Primary Health Care and the proposal to overcome them were pointed out. It was concluded that, under the managers’ perspectives, nurses can greatly contribute to Children’s Health Surveillance in Primary Health Care as members of the health care team; however, to that end, they need professional qualification, structural conditions and institutional support with that regard

Avaliação da qualidade de cápsulas de finasterida manipuladas na Farmácia Escola “Prof. Dr. Antônio Alonso Martinez”

Medicamentos manipulados são preparados nas farmácias ou nos serviços farmacêuticos hospitalares pelo profissional farmacêutico ou sob sua direta responsabilidade, a partir de prescrições médicas ou de fórmulas inscritas no Formulário Nacional ou Formulários Internacionais reconhecidos pela Anvisa. No Brasil, o consumo desses produtos mostra um crescimento importante no cenário da Saúde Pública. A finasterida é um fármaco representativo de uma grande parcela desse mercado por seu fácil acesso e alta eficácia. Contudo, a manipulação deste produto deve ser realizada com bastante cautela, por ser um medicamento de baixa dose. Nesse meio, a Farmácia-Escola “Prof. Dr. Antonio Alonso Martinez” conquista a confiança da população de Araraquara e região há muitos anos. A fim de se fundamentar essa confiança, o presente trabalho tem por objetivo analisar cápsulas de finasterida manipuladas na Farmácia Escola supracitada por Cromatografia Líquida de Alta Eficiência (CLAE), utilizando metodologia devidamente validada. Foram analisados parâmetros como teor e uniformidade de conteúdo das cápsulas, bem como teor da matéria-prima e da mistura de pós destinados ao preenchimento de cápsulas. Os resultados encontrados apresentam-se dentro dos critérios adotados pelas Farmacopeias Americana e Europeia, uma vez que a Farmacopeia Brasileira ainda não tem monografia inscrita da finasterida e dos respectivos medicamentos