Levantamentos epidemiológicos em saúde bucal: análise da metodologia proposta pela Organização Mundial da Saúde

Epidemiological surveys are important for obtaining information on the prevalence and etiology of mouth diseases, since the data collected permit health actions to be planned, performed, and assessed. Methodological uniformity is necessary, however, to maintain reproductibility, validity, and reliability, and to allow national and international comparisons. The initiative of the World Health Organization (WHO) as an advisor in ongoing surveys has been extremely useful, stimulating standardization in all countries. In 1991, a Portuguese version of the 1987 third edition of Oral Health Surveys - basic methods, an instruction manual for performing epidemiological surveys, was published and became a reference for many parts of Brazil and the World. The present analysis found conflicting points in relation to the sample size, calibration of the examiners, and criteria for evaluating oral health and treatment needs. In conclusion, due to the dynamic characteristics of scientific knowledge and, considering the regional differences in relation to the development of oral diseases, we recommend that proposals for standardizing surveys be checked periodically. Other important issues may have not been detected in this analysis, urging a thorough discussion within the dentistry community as a whole.

Levantamentos epidemiológicos em saúde bucal: análise da metodologia proposta pela Organização Mundial da Saúde

Epidemiological surveys are important for obtaining information on the prevalence and etiology of mouth diseases, since the data collected permit health actions to be planned, performed, and assessed. Methodological uniformity is necessary, however, to maintain reproductibility, validity, and reliability, and to allow national and international comparisons. The initiative of the World Health Organization (WHO) as an advisor in ongoing surveys has been extremely useful, stimulating standardization in all countries. In 1991, a Portuguese version of the 1987 third edition of Oral Health Surveys - basic methods, an instruction manual for performing epidemiological surveys, was published and became a reference for many parts of Brazil and the World. The present analysis found conflicting points in relation to the sample size, calibration of the examiners, and criteria for evaluating oral health and treatment needs. In conclusion, due to the dynamic characteristics of scientific knowledge and, considering the regional differences in relation to the development of oral diseases, we recommend that proposals for standardizing surveys be checked periodically. Other important issues may have not been detected in this analysis, urging a thorough discussion within the dentistry community as a whole.

Construção e validação do instrumento de investigação do conhecimento de gestantes sobre sua saúde bucal e a do seu bebê: perspectiva do cuidado em saúde

INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach α ˃ 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women’s knowledge about their oral health and the oral health of their baby.

Construção e validação do instrumento de investigação do conhecimento de gestantes sobre sua saúde bucal e a do seu bebê: perspectiva do cuidado em saúde

INTRODUCTION: Humanized and quality prenatal and post-partum care is critical to maternal and newborn health, as well as oral health care. Currently, the National Oral Health Policy is aiming at expanding dental care for pregnant women. Thus, the promotion of oral health and attention to prenatal care policies should be integrated; however, there is still limited participation of pregnant women. Thus, it is necessary to verify the knowledge of pregnant women related to oral health, seeking to estimate the quality of dental care provided during prenatal care, being essential for the Family Health strategy to organize personnel, plan costs and to ensure the quality standard of care. OBJECTIVE: To develop and validate a research instrument on the knowledge of pregnant women about their oral health and of their baby. METHOD: This is a construction and validation study with 93 pregnant women in Family Health Units and specialized private clinics in Obstetrics, in the city of Natal / RN. It was authorized by the Onofre Lopes University Hospital Ethics Committee of the Universidade Federal do Rio Grande do Norte (UFRN) under the registration number 421.163/13. The construction of the instrument followed steps so that it was valid, reliable and sensitive: creation and reduction of the items (drafting of the instrument), content validity and testing of the instrument, and hypotheses validation. Once constructed, the instrument was evaluated by experts who suggested modifications. There was consultation with the target population about the new version of the created instrument, which had the instrument validation verified by internal consistency through intra and inter-calibration and test-retest. Next, the hypotheses were validated. A database was built in the Statistical Package for Social Sciences (SPSS), version 22.0. After creating the hypotheses, an association was found for validating the criteria between each of the specific issues for each established criteria, considering a 5% significance level. Data analysis was carried out by describing the absolute and relative frequencies of the variables pertaining to issues relating to their pregnancy knowledge about their oral health and their baby. The Kappa coefficient was used for the calibration process (Inter and Intra-examiner calibration) and Cronbach's alpha coefficient was used to analyze instrument reproducibility (test-retest). In addition, the chi-square test was used to cross the dependent variable with the (dichotomized) independent variables. RESULTS: The intra and inter agreement analysis presented a Kappa coefficient between 0.400 and 1.000. Internal consistency through the analysis showed that 90% of the instrument's questions showed great reliability in the answers (Cronbach α ˃ 0.7). In the investigation of the relationship between the dependent variable (knowledge about oral health) and the independent variables (trimester of pregnancy, education, income and multiparous), it was found that none of these independent variables were significantly associated. All hypotheses had their Ho confirmed. CONCLUSION: The constructed instrument was validated, considering that it showed to be sensitive with good reliability and good accuracy, and therefore can be used to assess pregnant women’s knowledge about their oral health and the oral health of their baby.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Estratégias de promoção da saúde a partir da escola e da Unidade Básica de Saúde da Família, em Uberlândia (MG)

Health promotion is opposed directly to the biomedical model and established by intersectoral action, with collective and interdisciplinary approaches, considering the subject in their life contexts. Build healthy territories is to promote health, which necessarily includes intersectoral coordination and community mobilization. The health and education sectors can work together to promote health, developing so articulate actions and practices involving the subject in its territory of life and work. This study aimed to design and experience of health promotion strategies in school and Basic Health Units Family in Uberlândia - MG, from intersectoral relationship and community mobilization. The methodological research route was action research, or research intervention, because while researching already applied the ideas to solve problems through collective action. The research began in the Municipal School of Basic Education Prof. Eurico Silva, with the Health Centre's deployment to carry out surveillance and health promotion with active participation of students, involving all subjects of the school, students, teachers and other staff in the context of everyday life, which extrapolates the school walls, reaching the family and social groups in the community to which they belong. The health observatory has the objective existence with the establishment of the working groups, which at first were "healthy eating" and "drug-free world" and later, "dengue". The themes were chosen by the participants of the Health Centre, in which each is involved preferably. The second part of the research started with the approach between the Centre for Health and the health units (UBS and BFHU). The proposal was that the schools and the health nurse unit together should undertake prevention and health promotion, combating Aedes aegypti with intersectoral coordination and community mobilization. For it was crucial the involvement of ACS, ACE, ASE and the nurse coordinator of the Health Unit in creating community networks in the territory. home visits, community mobilization and intersectoral coordination: a training course in all BFHU and UBS teams with the following subjects was conducted. At this stage, were the Health Units that should approach the schools, in order to provide community networks to fight Aedes aegypti in each territory. The results and the scope of this experiment could only be brought to fruition because the Board of Health Surveillance and Care Coordination council of Basic embraced the proposal and helped in its implementation. It remains to continue consolidating this process of work in health units of primary care and the elementary schools, replicate the Health Centre's experience at school. The conclusion of this work is that schools and care facilities to health together with intersectoral coordination and community mobilization supported by community networks, can carry out prevention and health promotion, from a health model that considers the social determinants of health and overcoming hygienist model / sanitarian.

Sexualidade e saúde mental: construindo sentidos entre pessoas usuárias de um CAPS

When expressed by mental health services users, sexuality is typically denied by professionals, viewed as another symptom or as if these people are not capable of practicing it. Once Brazilian health professionals haven’t shown lots of investment in this theme, and few are the studies in this field, it is necessary the attention to be focused on researches involving this public. Therefore, the main goal of this study was understand the meanings of sexuality of the mental health services users, which were negotiated in sexuality workshops. The secondary goals were: a) understand the meanings of themes about sexuality brought by users through their experiences of everyday life; b) to evaluate the facilitating experience of the workshops on sexuality at CAPS. Thus, 10 workshops on sexuality were held, with an average of an hour and twenty minutes each, distributed from December 2014 and April 2015. There were 43 participants, 29 women and 14 men. The meetings had the following central themes: sexuality; sexuality and mental health; myths, beliefs and sexual taboos; gender identity; sexual orientation; sexual and reproductive rights; safe sex; and STD/AIDS. The data collection was through audio-recording of these meetings. Later, was made the transcript of the workshops, a careful reading of these transcripts and then its analysis. It was identified categories to analyze the interfaces that permeate the focus of the study. Initially, the categories relating to mental health and sexuality: meanings about sexuality; gender issues; gender and religion; sexual rights, STD/AIDS prevention and attention or denial of sexuality at CAPS. Later, those relating to the workshops facilitating process: challenges in facilitating the workshops; and the perception of the participants. A variety of meanings about sexuality could be noticed in the users’ statements, relating it more with affection and respect than with intercourse. The gender issues that emerged during the workshops were related to marital relationship, sexism, domestic violence, psychological violence and male and female roles in society. Moreover, were also revealed some situations that associated gender differences with religious issues, such as the submission of women and homosexuality. It was also noticed some experiences of the participants involving worrying situations of family violence, suicidal ideation and chemical castration, were often mismanaged or ignored by the service professionals. With regard to the facilitation of the workshops, it was possible to legitimize it as places where users were able to talk openly about the suggested themes and highlight its importance to the study site. Besides, it’s possible to list a few challenges of its facilitation in a mental health service, which was in general positively evaluated by the participants. Thus, the research highlights the need for sexuality theme discussion in mental health services, in order to understand, discuss and inform the users. Also, it’s important to problematize the stigma created in the theme relation with the users, the professionals and the society, working its specificities and avoiding a pathological bias.

Associação entre comprometimento motor, mobilidade e qualidade de vida em crianças com paralisia cerebral espástica, nível I, II e III do Gross Motor Function Classification System

The objective of this study was to verify the association between some mobility items of the International Classification Functionality (ICF), with the evaluations Gross Motor Function Measure (GMFM-88), 1-minute walk test (1MWT) and if the motor impairment influences the quality of life in children with Cerebral Palsy (PC), by using the Paediatric Quality of Life Inventory (PedsQL 4.0 versions for children and parents). The study included 22 children with cerebral palsy spastic, classified in levels I, II, and III on the Gross Motor Function Classification System (GMFCS), with age group of 9.9 years old. Among those who have participated, seven of them were level I, eight of them were level II and seven of them were level III. All of the children and teenagers were rated by using check list ICF (mobility item), GMFM-88, 1-minute walk test and PedsQL 4.0 questionnaires for children and parents. It was observed a strong correlation between GMFM-88 with check list ICF (mobility item), but moderate correlation between GMFM-88 and 1-minute walk test (1MWT). It was also moderate the correlation between the walking test and the check list ICF (mobility item). The correlation between PedsQl 4.0 questionnaires for children and parents was weak, as well as the correlation of both with GMFM, ICF (mobility item) and the walking test. The lack of interrelation between physical function tests and quality of life, indicates that, regardless of the severity of the motor impairment and the difficulty with mobility, children and teenagers suffering of PC spastic, functional level I, II and III GMFCS and their parents have a varied opinion regarding the perception of well being and life satisfaction.

Saúde da população “trans”: uma revisão sistemática da produção teórica brasileira

This dissertation analyzed the existing work on travestility and transsexuality whose problematic research focused on issues related to health and / or health services. For this purpose, a Literature Review Systematized Descriptive in virtual databases was performed: Bank of Higher Education Personnel Improvement Coordination Thesis (CAPES), Brazilian Digital Library of Theses and Dissertations (BDTD), Scielo and PubMed, between the years 1997 and 2014 in Brazil. We used the search terms "transsexual," "transvestite" and "transgender", each associated with the search term "health", in Portuguese and English. Complementing this search, we used the Documentary Analysis methodology to assess pamphlets productions, institutional documents and non-governmental organizations (NGOs), which were incorporated into the discussion. 295 papers were identified, among theses, dissertations and scientific articles. Of these, 223 were excluded and 72 selected for analysis. Thus, it obtained five theses and dissertations 21 on the topic of travestility and 7 theses and dissertations 9 that deal with transsexuality. Among the selected papers, 16 deal with transsexuality and health, 5 address the issue of travestility and health and work, 9 refer to the term "transgender" and "health". Even though it is an emerging field of research, there is an apparent deviation of the speech, previously anchored in questions whose topics are related to confrontation, infection or illness by HIV / AIDS (level of specialized care) for discussions on the health care for transsexuals in the process (level of specialized care). Still, few papers have specific trans attention in primary care associated with a comprehensive health care, with the empowerment of individuals, respecting the power of life, which are configured as important issues for the Public Policy on Health today.

Pelo olhar de quem não sente a diferença : comparação dos Cores Sets da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para a Paralisia Cerebral com a perspetiva de crianças/ jovens e cuidadores, de Portugal

Introdução: A CIF foi considerada, por alguns clínicos, como não sendo totalmente viável para a aplicação na rotina clínica, já que este sistema de classificação contém mais de 1400 categorias. Posto isto, o processo de desenvolvimento de Core Sets da CIF tem sido priorizado pela OMS, tornando a CIF acessível para a avaliação das cs específicas. Estes pretendem orientar uma avaliação multidisciplinar abrangente, incluindo as categorias da CIF para descrever, de uma forma suficiente, a funcionalidade e incapacidade dos indivíduos. Contudo, podem existir divergências entre a perspetiva de crianças e jovens portugueses com PC e cuidadores sobre a sua cs e os core sets da CIF estabelecidos para a mesma. Objetivo: Identificar os problemas percecionados pelas crianças e jovens com paralisia cerebral e pelos cuidadores em Portugal e analisar em que medida estes aspetos são representados pela versão atual do Comprehensive Core Set da CIF para esta cs. Metodologia: Este estudo é qualitativo, tendo-se utilizado uma amostra conveniente de crianças/jovens com PC e cuidadores. Todos os dados foram recolhidos por meio de entrevistas e posteriormente analisados segundo o protocolo de Coenen. Foi efetuado o linking dos conceitos obtidos das entrevistas para as categorias da CIF, tendo sido comparadas com os Core Sets da CIF para esta condição. Resultados: Este estudo tem uma amostra de 48 indivíduos, sendo que 28 eram crianças e jovens com PC e os restantes 20 eram cuidadores. A média de idades das crianças/jovens incluídos foi 13,04 (±3,26), sendo que a idade mínima incluída foi 8 anos e a idade máxima, 18 anos. A média de idades dos cuidadores incluídos foi de 35,20 (±8,01) anos, sendo que a idade mínima incluída foi 22 anos e a idade máxima 55 anos. Das 256 categorias identificadas, 101 estão contempladas nas categorias dos Comprehensive Core Set da CIF. Estas encontram-se presentes em 58 categorias de 2º nível dos Comprehensive Core Set de um total de 135, correspondendo a 43% dos mesmos. Conclusões: Tendo em conta os resultados obtidos, podemos concluir que os Comprehensive Core Set da CIF para a PC contemplam a grande maioria dos problemas percecionados pela população-alvo, ainda que integre várias categorias que não foram relevantes para esta população em estudo.

Literacia em saúde mental acerca da depressão e abuso de álcool de adolescentes e jovens Portugueses

RESUMO Objetivo: Este estudo tem como objetivos comparar a literacia em saúde mental dos adolescentes e jovens portugueses, relativamente à depressão e ao abuso de álcool e analisar o padrão de respostas em termos de consistência e concordância para ambas as perturbações. Método: A amostra é constituída por 4938 adolescentes e jovens, 43,0% do sexo masculino e 56,7% do sexo feminino, com uma média de idades de 16,75 anos (desvio padrão = 1,62 anos), que frequentam as escolas do 3.º ciclo do ensino básico e do ensino secundário, pertencentes à Direção Regional de Educação do Centro. Para a colheita de dados foi utilizado o QuALiSMental (LSM). Resultados: Os resultados revelam um nível de LSM modesto na generalidade das componentes. Ainda que se encontrem diferenças estatisticamente significativas (p < 0,05) em 88,0% dos itens da LSM, o que indicia diferentes formas de encarar ambos os problemas de saúde mental, os resultados revelam consistência, em termos das componentes conhecimentos e competências para prestar a primeira ajuda e apoio aos outros e conhecimentos acerca do modo de prevenção das perturbações mentais. ABSTRACT Objectives: This study aims to compare mental health literacy of adolescents and young Portuguese in what concerns depression and alcohol abuse and analyzes the pattern of responses in terms of consistency and agreement for both disorders. Method: The sample consisted of 4938 adolescents and young people, 43.0% males and 56.7% females with a mean age of 16.75 years (standard deviation = 1,62 years), who attend schools of the 3rd cycle of basic education and secondary school, belonging to the Regional Education Directorate – Center. For data collection was used QuALiSMental (MHL). Results: The results showed a modest level of MHL in most components. Although there are statistically significant differences (p < 0.05) in 88.0% of the items of MHL, suggesting different ways of looking to both mental health problems, the results show consistency in terms of the components of knowledge and skills to providing first aid and support to others and knowledge about the prevention of mental disorders.

Saúde bucal no Programa de Saúde da Família : o caso do Distrito Sanitário Norte de Natal-RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health

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

Centro de dia e lar: saúde mental de idosos e capacidade para o trabalho dos seus cuidadores formais

O Envelhecimento da população é uma realidade cada vez mais presente na nossa sociedade. A investigação junto da população idosa e dos seus cuidadores requer que sejam criadas condições para que, estes grupos, possam usufruir de uma boa qualidade de vida. Propõe-se analisar a capacidade de trabalho dos cuidadores formais de idosos em contexto institucional mas com modalidades de trabalho distintas, no Centro de Dia, onde praticam um horário diurno e fixo, em paralelo com o horário por turnos rotativos diurnos/noturnos praticados no Lar. Foi proposto também analisar o estado mental dos idosos dessas mesmas instituições. A amostra deste estudo contou com 90 participantes dos quais 50 idoso e 40 cuidadores formais. Utilizou-se para a recolha de dados com os idosos o MMSE – Mini-Mental State Examination e a GDS-30 – Escala de Depressão Geriátrica, com os cuidadores a Escala de Graffar e o ICT – Índice de Capacidade para o Trabalho. Os resultados demonstraram não existirem diferenças significativas ao nível da demência e da depressão entre os idosos do Lar e do Centro de Dia. Outros resultados refletiram, para os cuidadores formais, uma capacidade para o trabalho excelente, ligeiramente superior aos dados de referência. Não foi conseguida uma relação entre a saúde mental dos idosos e a capacidade de trabalho dos seus cuidadores formais o que pode retratar o sucesso das medidas de apoio e educação desenvolvidas nesta área.