Men's experience of caring for a family member with cancer: a theory based on data

OBJECTIVE

to understand the meaning attributed by men to the experience of caring for their family member with cancer and to develop a substantive theory that represents the experience of men caring for their family member with cancer.

METHOD

this is qualitative research guided by the methodological framework of Grounded Theory and the precepts of Symbolic Interactionism. A form with identification and interview data was used. The analysis followed the substantive and theoretical coding stages.

RESULTS

12 male caregivers of their family member with cancer participated. The constant comparative analysis of the data allowed the creation of a substantive theory "Experiencing the care of a family member with cancer: men as a caregivers" explaining the experience that has as its central category "The love that drives care", representing the symbolic actions and attitudes of men living in the context of illness due to cancer and care.

CONCLUSION

the theory allowed us to understand feelings, perceptions, ways of acting and facing the diagnosis, providing care, recognizing difficulties and learning from the situations that arise, making explicit the interactional processes and symbolic elements present and how these influence male caregivers in their actions and attitudes.

BACKGROUND

(1) For men, caring is a choice (2) Taking care symbolizes a way of expressing love and reciprocation. (3) Love in caring is strengthened by reciprocity, commitment, gratitude and zeal. (4) To provide care, man reorganizes himself and adjusts to the conditions that present themselves (5) Male caregivers need to be heard and included in the actions of health teams.

Geoprogrammatic disparities in the performance of tuberculosis indicators in the homeless population in Brazil: an ecological approach

OBJECTIVE

To analyze the performance and spatial distribution of tuberculosis control indicators in the homeless population in Brazil.

METHODS

Ecological study, which had the regions and federal units of Brazil as the unit of analysis. The indicators considered, referring to the period from 2015 to 2021, were: proportion of HIV testing, proportion of tuberculosis-HIV co-infection, proportion of directly observed treatment, and proportion of outcomes (cure, treatment abandonment and death). The calculation was performed on each ecological unit, as recommended by the Ministry of Health. For the production of geographic figures, the technique of natural breaks was used.

RESULTS

It was identified that people living on the streets had: low HIV testing, especially in Pará (71.7%); high proportion of tuberculosis-HIV coinfection, especially in Rio Grande do Sul (39.9%); and unsatisfactory implementation of directly observed treatment, mainly in Paraíba (7.7%). With regard to outcomes, there was a high rate of treatment abandonment, with a higher proportion in Roraima (52.9%), and a high number of deaths, with an emphasis on Mato Grosso do Sul (23.1%), which also recorded the worst cure rate (28.7%).

CONCLUSION

There was evidence of poor performance of tuberculosis control indicators in homeless people, with heterogeneous distribution between states and regions of the country, and it is clear that most of them had insufficient results. These data raise the persistence of difficulties and challenges inherent to the implementation of tuberculosis control strategies for this population in the national territory.

Development of a mobile application for emergency shift handovers using the National Early Warning Score

OBJECTIVE

To develop and validate a prototype of a mobile application shift handover between nurses in the emergency room using a severity scale.

METHOD

This is a technological tool carried out at the Universidade Estadual de Maringá using design thinking, divided into four phases: discovering, defining, developing, and delivering. To structure the information, a checklist was used based on the Situation Background Assessment Recommendation, and to categorize patients in terms of severity, the National Early Warning Score was used. The validation of the sample was carried out by 10 nurses, specialized in the field of urgency and emergency, using the System Usability Scale questionnaire to assess usability. The content validity coefficient was used for analysis.

RESULTS

The application scored 75.75 in usability and had a content validity coefficient of 0.8.

CONCLUSION

The prototype obtained an excellent evaluation of usability and agreement between evaluators. Future studies are needed for implementation in practice, evaluating the practicality, applicability, efficiency and time savings in shift information transfer.

Assessment of the Psychosocial Care Center multidisciplinary team from users' and family members' perspective

OBJECTIVES

to assess the multidisciplinary team of a Psychosocial Care Center I from users' and family members' perspective.

METHODS

an evaluative study, anchored in the fourth generation evaluation theoretical-methodological framework, carried out in a Psychosocial Care Center I, from September 2021 to March 2022. Eleven users and 06 family members participated. Data were collected through non-participant observation, individual interviews and negotiation sessions, and analyzed using the Constant Comparative Method, using the MAXQDA software.

RESULTS

the team develops its care based on individual and collective care, with integrated and complementary work by professionals. They seek to facilitate treatment initiation and continuation, considering health needs and offering support, understanding and guidance to users and their families.

FINAL CONSIDERATIONS

the multidisciplinary team's work is based on the psychosocial paradigm, which can qualify care and strengthen the service role in the mental health network.

UTILIZAÇÃO DA GROUNDED THEORY NA EXTRAÇÃO, CODIFICAÇÃO E ANÁLISE DE DADOS EM METASSÍNTESES DE LITERATURA

RESUMO Objetivo: descrever a condução de extração, análise e codificação de dados utilizando a Grounded Theory, na perspectiva Straussiana, em Metassínteses de literatura. Método: trata-se de um ensaio teórico-reflexivo sobre a condução da extração de dados de revisões com metassíntese. Para delineamento do processo de busca dos estudos qualitativos, este ensaio aborda, de forma sucinta, as etapas sequenciais do Preferred Reporting Items for Systematic Review and Meta-Analyses e da Joanna Briggs Institute. O processo de extração, análise e codificação foi realizado seguindo os pressupostos da Grounded Theory, com a perspectiva Straussiana. São as bases teórico-metodológicas nas primeiras etapas das diretrizes dos guias de revisão de literatura e Metassíntese, iniciando com a pergunta de pesquisa até chegar às etapas da revisão, divididas em identificação, seleção, elegibilidade e inclusão. Resultados: nos resultados são descritos o processo de extração, análise e codificação de dados na perspectiva Straussiana, com uso de análise comparativa dos dados, memorandos, diagramas e possibilidades de novos grupos amostrais a partir da leitura analítica minuciosa dos estudos inclusos. Por fim, é realizada a saturação teórica, com síntese dos achados, com exemplos de categorias e subcategorias, emersão do fenômeno central e apresentação da modelo paradigmático. Conclusão: o ensaio apresenta subsídios para a compreensão da condução de extração, análise e codificação de dados em Metassínteses baseada na perspectiva Straussiana, possibilitando, de forma sistematizada, a síntese de evidências qualitativas e contribuindo no desenvolvimento de modelos ou teorias de caráter conceitual.

Morbidity and mortality and factors associated with death in hospitalized patients resulting from the impacts of alcohol and other drugs

Abstract Objective To describe the hospitalizations resulting from the impacts of alcohol and other drug abuse and factors associated with death. Methods Cross-sectional, observational, and retrospective study, with secondary data from 3,562 admissions recorded at the Center for Information and Toxicological Assistance of a teaching hospital in northwest Paraná, using epidemiological surveillance of active search, from 2009 to 2018. Data were processed using univariate analysis (Pearson’s Chi-square test and Fisher’s exact test). Results Most were males (89.6%), and the mean age was 43.62 years (±16 years). Most hospitalizations resulted from traumatic events and other external causes (52.1%) associated with the use/abuse of alcoholic beverages (85.8%). The mean length of hospital stay was 34.6 days, and 6.0% died. There was an association between risk of death and endocrine/metabolic, cardiovascular, gastrointestinal, and genitourinary diseases. Conclusion Hospitalizations with greater severity increase the incidence of deaths, and evidencing the associated factors directs interventions to decrease hospitalizations, reducing complications and deaths. Implications for practice The studies serve as a support for the development of prevention strategies, encouragement for improvement actions in the assistance network for users, strengthening and increasing public policies.

Morbimortalidade e fatores associados ao óbito em internados por efeitos do álcool e outras drogas

Resumo Objetivo descrever as internações por efeitos do abuso de álcool e outras drogas e os fatores associados ao óbito. Métodos estudo transversal, observacional e retrospectivo, com dados secundários de 3.562 internações registradas no Centro de Informação e Assistência Toxicológica de um hospital de ensino no noroeste do Paraná, por vigilância epidemiológica de busca ativa, entre os anos 2009 e 2018. Os dados foram tratados por análise univariada (teste do qui-quadrado de Pearson e teste exato de Fisher). Resultados houve predomínio do sexo masculino (89,6%), e a média de idade foi de 43,62 anos (±16 anos). A maioria das internações foi por eventos traumáticos e outras causas externas (52,1%) associadas ao uso/abuso de bebida alcoólica (85,8%). O tempo médio de internação foi de 34,6 dias; 6,0% evoluíram a óbitos. Houve a associação entre o risco para óbitos e doenças endócrinas/metabólicas, cardiovasculares, gastrintestinais e geniturinárias. Conclusão as internações com maior gravidade aumentam a incidência de óbitos, e a identificação dos fatores associados direcionou as intervenções para a redução de internações, minimizando as complicações e os óbitos. Implicações para prática este estudo serve como subsídio para o desenvolvimento de estratégias de prevenção e estímulo para as ações de melhoria na rede assistencial aos usuários, fortalecendo e incrementando as políticas públicas.

USE OF GROUNDED THEORY IN THE EXTRACTION, CODING AND ANALYSIS OF DATA IN LITERATURE META-ANALYSES

ABSTRACT Objective: to describe the conduction of data extraction, analysis and codification using the Straussian perspective of Grounded Theory, in Literature Meta-analysis. Method: this is a theoretical-reflexive study on the data extraction from reviews with meta-anaylses. To design the process of searching for qualitative studies, this study briefly addresses the sequential steps of Preferred Reporting Items for Systematic Review and Meta-Analyses and the Joanna Briggs Institute. The extraction, analysis and codification process were carried out following the assumptions of grounded theory, with the Straussian perspective. They are the theoretical-methodological bases in the first stages of the guidelines of the literature review and Meta-analyses guides, starting with the research question until reaching the review stages, divided into identification, selection, eligibility, and inclusion. Results: the results describe the process of data extraction, analysis and codification from the Straussian perspective, using comparative analysis of data, memoranda, diagrams and possibilities of new sample groups from the detailed analytical reading of the included studies. Finally, theoretical saturation is performed, with an analysis of the findings, with examples of categories and subcategories, the emergence of the central phenomenon and presentation of the paradigmatic model. Conclusion: the essay presents subsidies for the understanding of the conduction of extraction, analysis and codification of data in meta-analyses based on the Straussian perspective, enabling the systematized analysis of qualitative evidence and contributing to the development of models or theories of conceptual character

Construction and validation of clinical scenarios for training informal caregivers of dependent persons

OBJECTIVE

To construct and validate three clinical scenarios for training dependent persons' informal caregivers.

METHODS

Methodological study, conducted between January and August 2021, in a municipality in the northwest of the state of Paraná. It was developed in two stages: construction of scenarios; and content validation by experts (n = 12). To estimate the degree of agreement between the experts, the content validity index was used, and 80% was considered an acceptable rate of agreement.

RESULTS

The simulation scenarios proved appropriate, obtaining an average value of 91.6%. However, some adjustments were made in their organization pertaining clarity in the wording of guidelines, as suggested by the expert validators.

CONCLUSIONS

The construction and validation of the clinical scenarios proved to be adequate and relevant for use in the training of informal caregivers of dependent persons.

Validation of the Informal Caregiver Burden Assessment Questionnaire for Brazil - short version

OBJECTIVES

to cross-culturally adapt the short version of the Informal Caregiver Burden Assessment Questionnaire to the Brazilian culture and test its psychometric properties.

METHODS

the questionnaire was translated, adapted, and applied to a sample of 280 informal caregivers. The psychometric assessment was verified by estimating psychometric sensitivity and internal structure validity.

RESULTS

inter-rater agreement was satisfactory among specialists. In the seven-factor model, item (Q9) of the domain "Perception of Efficacy and Control Mechanisms" showed a factor loading less than 0.40 (ʎ = 0.26), and an alternative six-factor model was evaluated. However, both models showed excellent fit indices, and it was decided to keep the seven-factor reference model. Reliability was satisfactory for the seven subscales (α > 0.70).

CONCLUSIONS

the questionnaire was adapted and showed adequate psychometric indices in the Brazilian context in which it was evaluated, preserving its original essence.

Tendência temporal da incidência dos casos de HIV/Aids no Noroeste do Estado do Paraná

Objetivou-se analisar a tendência temporal das taxas de incidência dos casos de HIV/Aids no noroeste do Estado do Paraná. Estudo ecológico, de análise de séries temporais com dados referentes às notificações de HIV/Aids na 15ª Regional de Saúde do Estado do Paraná no período de 2009 a 2019. O acesso ao sistema de informação de notificação e agravos ocorreu no mês de junho de 2020. Foi utilizado o teste de Mann-Kendall para verificar a existência de tendência nas séries anuais de casos. A série total apresentou tendência crescente, e o aumento mais expressivo foi em homens (tau de 0,96) acima de 65 anos e de 20 a 34 anos (0,64 e 0,56, respectivamente), com ensino superior e médio (0,89 e 0,78, respectivamente). Não houve aumento significativo nos óbitos. Observou-se crescimento da tendência temporal na maioria das taxas analisadas de incidência dos casos de HIV/Aids.

Longitudinal treatment of smoking in Primary Health Care: an evaluation research

ABSTRACT Objectives: to evaluate the coordination of the attention for continuing treatment for smoking cessation in the Primary Health Care, from the perspective of users. Methods: the conceptual base was longitudinal care, which is an attribute of the National Policy of Primary Care. The methodological framework was that of an evaluative research, as informed by theory-based evaluation. Data collection used observation with moderate participation in the groups to abandon smoking, intensive interviews with 22 users, and analysis of medical records. The interviews used initial and focused coding, which are analytical stages of the Grounded Theory, with the aid of the MaxQDA® software. Results: the interviewees had a positive evaluation of their treatment for smoking, although they mentioned limitations for medium- and long-term continuity. Final Considerations: the smoking treatment sessions, even if infrequent, were found to be a successful experience for smoking cessation.

DAILY LIFE OF FAMILIES AND COVID-19: IN THE LIGHT OF THE COMPREHENSIVE SOCIOLOGY OF MICHEL MAFFESOLI

ABSTRACT Objective to understand the changes that occurred in family daily life faced with illness and/or death of a family member by Covid-19. Method exploratory, analytical, qualitative study, rooted in The Comprehensive Sociology and Daily Life of Michel Maffesoli. Data were collected between September and October 2021 in the municipalities of Maringá, Colorado, Mandaguaçu and Floriano district. Participants were 19 families with at least one family member who became ill and/or died by Covid-19. The sampling was by the non-probabilistic Snowball technique. The in-depth technique was used to explore the daily lives of families. The content of the speeches was organized through thematic analysis. The interpretative synthesis was constructed and discussed from the theoretical framework. Results a category called "Familial daily life after illness and/or loss by Covid-19", emerged from the convergence between the reference which was divided into two subcategories: "Changes in daily life and family functioning" and "Changes after the loss of a loved one". Thus, in the analysis, it was found that the changes in family daily life were permeated by obstacles that were caused by financial and physical limitations or the absence of the element (key person) that once gave solidity to the family unit. Conclusion the daily life of families was profoundly modified, changes negatively affected socio-family relationships, from the most banal aspects of daily life to the more complex ones. This study contributes to the nursing practice and its understanding of an effective practice and supports the development of programs for the surviving families of Covid-19.

Nursing diagnoses in elderly people with diabetes mellitus according to Orem’s Self-Care Theory

ABSTRACT Objective: To identify nursing diagnoses and conditioning factors of self-care in older adults with diabetes mellitus, in the light of Orem’s Theory of Self-Care. Methods: Exploratory, descriptive study with a qualitative approach, conducted with the theoretical framework of Orem’s Theory of Self-Care. It was developed with 12 older people with diabetes, in a country’s southern municipality, between October and November 2019. For data collection, it was used individual interviews and focus groups. The data was submitted to thematic and content analysis directed to taxonomy II of NANDA International. Results: Twenty nursing diagnoses related to universal self-care requirements and health deviations were identified. All diagnoses were anchored in the supportive-education nursing system. Final considerations: The development of the disease and the consequences of chronic hyperglycemia were poorly recognized by the elderly, interfering with low adherence to self-care practices and disease control.

Construção e validação de cenários clínicos para capacitação de cuidadores informais de pessoas dependentes

RESUMO Objetivo: Construir e validar três cenários clínicos para capacitação de cuidadores informais de pessoas dependentes. Métodos: Estudo metodológico, realizado entre janeiro e agosto de 2021, em um município no noroeste do estado do Paraná. Foi desenvolvido em duas etapas: construção dos cenários; e validação do conteúdo por experts (n = 12). Para estimar o grau de concordância entre os juízes, utilizou-se o índice de validade de conteúdo, e considerou-se o valor de 80% como uma taxa aceitável de concordância. Resultados: Os cenários de simulação mostraram-se apropriados, obtendo valor médio de 91,6%. No entanto, foram feitos alguns ajustes em sua organização no que tange à clareza na redação das orientações, conforme sugestão dos juízes. Conclusões: A construção e validação dos cenários clínicos mostraram-se adequadas e relevantes, de modo que eles podem ser utilizados na capacitação de cuidadores informais de pessoas dependentes.

QUOTIDIANO FAMILIAL DIANTE DO ADOECIMENTO POR COVID-19: À LUZ DA SOCIOLOGIA COMPREENSIVA DE MICHEL MAFFESOLI

RESUMO Objetivo apreender as mudanças ocorridas no quotidiano familial diante do adoecimento e/ou morte de um membro familiar por Covid-19. Método estudo exploratório, analítico, qualitativo, ancorado na Sociologia Compreensiva e do Quotidiano de Michel Maffesoli. A coleta de dados ocorreu entre setembro e outubro de 2021, nos municípios de Maringá, Colorado, Mandaguaçu e no Distrito de Floriano. Participaram 19 famílias que tiveram ao menos um familiar que adoeceu e/ou faleceu por Covid-19. A amostragem foi por meio da técnica não probabilística Snowball. Utilizou-se a técnica em profundidade para explorar o quotidiano das famílias. Organizou-se o conteúdo das falas por meio da análise temática. As sínteses interpretativas foram construídas e discutidas a partir do referencial teórico. Resultados da convergência entre o referencial e os depoimentos emergiu uma categoria denominada “Quotidiano familial após o adoecimento e/ou perda por Covid-19,” dividida em duas subcategorias: “Mudanças no quotidiano e funcionamento familiar” e “Mudanças após a perda de um ente querido”. Assim, na análise, constatou-se que as mudanças no quotidiano familial foram permeadas por obstáculos que se configuraram por limitações financeiras, físicas ou a ausência do elemento (pessoa-chave) que, outrora, conferia solidez à unidade familiar. Conclusão o quotidiano familial foi profundamente modificado, as transformações incidiram negativamente sobre as relações sociofamiliares, desde os aspectos mais banais do cotidiano até os mais complexos. Este estudo contribui para o saber-fazer do enfermeiro na compreensão de uma prática efetiva, apoiando o desenvolvimento de programas de apoio às famílias sobreviventes da Covid-19.

Validação do Questionário de Avaliação da Sobrecarga do Cuidador Informal para o Brasil – versão curta

RESUMO Objetivos: adaptar transculturalmente a versão curta do Questionário de Avaliação da Sobrecarga do Cuidador Informal para cultura brasileira e testar suas propriedades psicométricas. Métodos: o questionário foi traduzido, adaptado e aplicado em uma amostra de 280 cuidadores informais. A avaliação psicométrica foi verificada pela estimativa da sensibilidade psicométrica e validade da estrutura interna. Resultados: a concordância interavaliadores foi satisfatória entre os especialistas. No modelo de sete fatores, o item (Q9) do domínio “Percepção dos Mecanismos de Eficácia e Controle” apresentou carga fatorial menor do que 0,40 (ʎ = 0,26), e um modelo alternativo de seis fatores foi avaliado. No entanto, os dois modelos evidenciaram ótimos índices de ajustamento, e optou-se por manter o modelo-referência de sete fatores. A confiabilidade mostrou-se satisfatória para as sete subescalas (α > 0,70). Conclusões: o questionário foi adaptado e demonstrou índices psicométricos satisfatórios no contexto brasileiro em que foi avaliado, preservando sua essência original.

Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory

ABSTRACT Objectives: to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity. Methods: this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework. Results: two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon “Re-signifying life after bariatric surgery” was constructed. Final Considerations: bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.

Factors associated with the skills of informal caregivers in home care

ABSTRACT Objective: To identify factors associated with cognitive, emotional, psychomotor, and relational skills of informal caregivers in home care. Methods: A cross-sectional study carried out with a sample of 216 informal caregivers residing in a municipality in the state of Paraná. Data collection took place between February and July 2019, with an instrument developed and validated to assess the skills of informal caregivers. Descriptive and inferential analyses were used. Results: The factors associated with a greater competence of informal caregivers were being female, having training in the field, and having more than five years home care experience. The lowest competence was observed in caregivers who had health problems and belonged to the lowest strata of family purchasing power. Participants had lower scores in psychomotor competence and had better results in cognitive competence. Conclusion: It was found that women with experience in care had higher levels of competence to provide quality care at home assistance services.

Competência de idosos cuidadores informais de pessoas em assistência domiciliar

Resumo Objetivos analisar a estimativa condicional do conhecimento, adaptação e preparo nas competências de idosos que exercem o papel de cuidadores informais de pessoas dependentes de cuidado em assistência domiciliar. Método estudo transversal, realizado com idosos cuidadores informais, residentes no município de Maringá, Paraná, Brasil. A coleta de dados foi realizada entre maio e julho de 2019 com um instrumento que avalia as competências cognitivas, psicomotoras, emocionais e relacionais de cuidadores informais de pessoas dependentes de cuidado em assistência domiciliar. O instrumento é constituído por 14 itens e três construtos: conhecimento, adaptação e preparo, sendo a escala de resposta Likert de cinco pontos. Utilizou-se análise de regressão linear para tratamento das variáveis. Resultados participaram do estudo 101 idosos cuidadores informais, e as estimativas condicionais das competências cognitiva e relacional apresentaram maior correlação com adaptação e o preparo. O melhor conhecimento estima maior desenvolvimento da competência psicomotora e cognitiva nas práticas de cuidado. Conclusão e implicações para a prática os conceitos hipotéticos de conhecimento, adaptação e preparo explicam o melhor desempenho das competências cognitiva, relacional e psicomotora de idosos cuidadores informais. Este resultado possibilita o desenvolvimento de novas intervenções educativas aos idosos que desempenham o papel de cuidador informal.

[Increase in the complaints of the elderly about supplemental health in Brazil]

The scope of this study was to describe the complaints of elderly Brazilians received by the National Supplemental Health Agency. It is an ecological study, with secondary data from the Integrated Inspection System. A trend analysis of the complaints received by the National Supplemental Health Agency of elderly beneficiaries from all over Brazil was conducted between 2008 and 2017. A total of 111,497 complaints were filed by elderly beneficiaries of the supplemental health system. The highest number of complaints (27.07) and the highest average annual increase (7.79, r2=0, 97), and the South region, with the lowest average rate for the period (7.11) and the lowest observed mean annual increase (1.84; r2=0.92) were identified. The highest rate of complaints was related to the coverage of the plan, between the elderly aged 70 to 79 and beneficiaries of individual or family plans. Growing dissatisfaction among older people with the supplemental health system reflected the large number of complaints received by the National Supplemental Health Agency over a period of nine years.

CONSTRUÇÃO E VALIDAÇÃO DE QUESTIONÁRIO PARA AVALIAÇÃO DAS COMPETÊNCIAS DO CUIDADOR INFORMAL

Objetivos: construir e validar o conteúdo e constructos de um questionário para avaliação das competências do cuidador informal. Método: estudo metodológico de construção e validação de questionário na área da saúde, realizado em um município da região noroeste do Paraná - Brasil. O questionário foi aplicado em dois grupos de 30 e 40 cuidadores informais. Participaram nove especialistas no comitê de juízes. Confirmou-se a validade de conteúdo, validade de constructo e verificação da consistência interna. Resultados: a construção apresentou quatro versões, sendo a última composta por duas partes, a primeira com 13 questões de caracterização sociodemográfica e a segunda com 14 itens específicos, ancorada em três constructos: competências cognitivo-emocionais, psicomotoras e relacionais. A versão final apresentou bom nível de concordância entre os juízes e consistência interna de α=89. Conclusão: o questionário serve como estratégia de avaliação dos cuidadores informais quanto ao nível de competência para executar o cuidado.

Construction and validation of self-care educational technology for caregivers

OBJECTIVES

to build and validate educational self-care technology for informal caregivers.

METHODS

methodological study, anchored in the Delphi technique, carried out in a municipality in the state of Paraná, Brazil, between September 2018 and November 2019. It was developed in three stages: situational diagnosis; elaboration of educational technology; content and appearance validation by expert judges and informal caregivers, using the content validity index and coefficient of variation.

RESULTS

after the steps of the methodological process, an educational technology called "Taking Care of Those Who Care" was produced, as an information tool that deals with the self-care of informal caregivers, receiving a content validity index above 0.86 and a variation coefficient. below 20% on all items.

CONCLUSIONS

the educational technology was built and evaluated with satisfactory rates by the specialists and target audience, showing a high correlation of agreement, characterizing it as adequate and informative to informal caregivers.

Cuidados paliativos: percepção da equipe multiprofissional atuante em uma Unidade de Terapia Intensiva

Este trabalho objetiva compreender a percepção da equipe multiprofissional atuante na Unidade de Terapia Intensiva sobre os cuidados paliativos. Trata-se de estudo exploratório, qualitativo. Os participantes foram 14 profissionais da equipe multiprofissional, atuantes na Unidade de Terapia Intensiva de um Hospital Municipal. A coleta de dados foi realizada entre julho e agosto de 2019, por meio de entrevista individual, semiestruturada, gravada e transcrita. Os dados foram processados no software Iramuteq e submetidos à análise de conteúdo de Bardin. Os resultados obtidos foram apresentados em três categorias: Cuidado paliativo: promoção do conforto na integralidade do indivíduo cuidado; Insegurança e fragmentação do cuidado paliativo: dificuldades da equipe multiprofissional; O profissional de saúde e o outro: integração com o paciente e família. Diante disso, os profissionais compreendem o cuidado paliativo como estratégia de promover o conforto e amenizar o sofrimento, respeitando a dignidade do paciente e o tratando como um ser integral e complexo.

Distribution and spatial autocorrelation of the hospitalizations for cardiovascular diseases in adults in Brazil

OBJECTIVES

To analyze the distribution and spatial autocorrelation of the hospitalization rates for cardiovascular diseases in adults, and to verify the correlation with socioeconomic and health factors in Brazil.

METHODS

An ecological study of hospitalization rates for cardiovascular diseases in adults from 2005 to 2016. Spatial dependence was analyzed by the Moran Global and Local autocorrelation coefficients. The correlation between hospitalization rates and socioeconomic and health variables was calculated using the Spearman's correlation coefficient.

RESULTS

The highest hospitalization rates were observed in the states of Santa Catarina, Paraná, São Paulo, and Mato Grosso, with high-high autocorrelation clusters for ischemic heart disease. The hospitalizations for cardiovascular diseases were strongly correlated with low schooling, alcohol consumption, and diagnosis of hypertension.

CONCLUSION

The high rates of hospitalization in the states mentioned, linked to socioeconomic and health factors, suggest public policies focused on the theme.

Construct validity and internal consistency of the Brazilian version of Leisure Attitude Measurement for the elderly

OBJECTIVE

To evaluate the construct validity and internal consistency of the Brazilian version of Leisure Attitude Measurement for the elderly.

METHOD

Methodological study with a quantitative approach. The data were collected for three months through domiciliary visits to a random and representative sample of 384 elders. The internal consistency was measured through Cronbach alpha coefficient. Construct validity was evaluated through exploratory factor analysis. Factor extraction was conducted per principal components, following the Kaiser criterion, with rotation through Varimax solution.

RESULTS

The participants' mean age was 70,9 and they were mostly women, married, living with relatives, with one to four years of education, and with an income of up to one minimum wage. The final model of the instrument has conserved three factors, under the parsimony criterion, explaining 50% of data variance, with a total of 27 items distributed across the cognitive, affective, and behavioral domains, with an overall Cronbach alpha coefficient of 0.89.

CONCLUSION

The proposed structural model has shown construct validity and an appropriate internal consistency, explaining 50% of data variability. Its application can promote the understanding of social reality and encourage a positive attitude and elderly engagement in leisure activities.

Satisfação de pessoas com hipertensão acerca dos atributos da Atenção Primária à Saúde

Estudo transversal, que avaliou a satisfação de pessoas com hipertensão acerca dos atributos da Atenção Primaria à Saúde. A coleta de dados ocorreu no primeiro semestre de 2016, utilizando um instrumento desenvolvido e validado, específico para população com hipertensão, que avaliou o acesso ao diagnóstico e ao tratamento; adesão/vínculo; elenco de serviços; coordenação do cuidado; enfoque familiar e orientação comunitária. Utilizou-se estatística descritiva e inferencial no tratamento das variáveis. Participaram do estudo 417 pessoas com hipertensão, que avaliaram como satisfatório as oito dimensões da atenção básica. A análise de regressão multivariada evidenciou que aqueles com controle pressórico inadequado possuíam maiores chances de avaliar o elenco de serviços e coordenação do cuidado como insatisfatórios. Conclui-se que os serviços ofertados foram avaliados como satisfatório na maioria das dimensões avaliadas, no entanto, as pessoas com inadequação pressórica apontam necessidade de melhoria na coordenação do cuidado e na integralidade dos serviços prestados.

Association between workaholism and quality of life in stricto sensu graduate professors in nursing

OBJECTIVES

to investigate the association between workaholism and quality of life in stricto sensu graduate professors in Nursing.

METHODS

a cross-sectional study developed with a total of 333 professors working in the Graduate Programs of Brazilian public universities. Data collection took place in the second semester of 2018, using an electronic form containing a characterization questionnaire, the Dutch Work Addiction Scale and the World Health Organization Quality of Life Instrument-BREF. The data were analyzed by univariate and multiple logistic regression.

RESULTS

it was observed that 82.3% of the professors reported low general quality of life and 19.5%, high level of excessive work and 20.1% of compulsive work. Professors who worked compulsively and excessively were less likely to have a high quality of life in the overall, physical, psychological, social relations and environment domains (p<0.05).

CONCLUSIONS

the high work demands that are characteristic of the stricto sensu professors' work process are directly associated with low quality of life.

Professional competency for elder care: perception among professors, nursing students, and nurses

OBJECTIVE

to know the perception of nurses, undergraduate students, and professors about the competencies for professional nurses in elder care.

METHODS

this is a qualitative analytical study developed with six professors, four nurses, and 12 nursing students. Data were collected through semi-structured interviews and analyzed using Fiorin's Discourse technique, with support from the MAXQDA software.

RESULTS

the competencies identified included knowledge of theories and general concepts of gerontology, communication, listening, leadership, teamwork, proactivity, respect, and empathy.

FINAL CONSIDERATIONS

knowing the competencies contributes to understanding the aging process and qualifying nurses for elder care.

Trend of transplants and organ and tissue donations in Brazil: a time series analysis

OBJECTIVES

to indentify the time trend of rates of organs and tissues effective donors, of reports and types of transplanted organs per million people of the Brazilian population.

METHODS

ecological study, of time series, about reports of organ donations and on transplants. The data were provided by the Registro Brasileiro de Transplantes and analyzed using polynomial regression.

RESULTS

an increasing trend was found for potential donors and effective donors, with an average increase of 2.33 and 0.92 per year, respectively. The South Region had the highest rate of potential donors (83.8) and effective donors (34.1) and the North Region, the lowest rate (20.2 and 3.9). The family refusal was the main obstacle to accomplish the donation.

CONCLUSIONS

the results show an increasing trend of potential donors and effective donors throughout Brazil, with emphasis on the southern region of the country. Among the main reasons for non-donation, it is worth emphasizing family refusal and medical contraindication prescription.

Effectiveness of nursing case management versus usual care for blood pressure control in adults with hypertension: a systematic review

OBJECTIVES

To synthesize the best available evidence regarding the effectiveness of nursing case management in primary health care, compared to usual care, in improving blood pressure in adults over 18 years with hypertension.

METHODS

Systematic review that includes studies carried out with adult patients diagnosed with hypertension, with or without other concomitant chronic diseases, followed-up by a case manager nurse, who evaluated the effectiveness of case management in the improvement of blood pressure. A critical evaluation of the studies was made and the results of interest were described using the instruments and tools from the Joanna Briggs Institute. Due to the heterogeneity of the included studies, the results of similar measures were not grouped in statistical meta-analysis. A narrative and tabular format was used to synthesize and present them.

RESULTS

Six randomized controlled trials were critically evaluated and included in the review. The total sample was 1963 participants. The results showed the outcomes compared at baseline and at the end of follow-up (six or twelve months). Regarding the main outcome, systolic and diastolic blood pressure, there was some reduction in the group followed-up through case management in studies lasting six months; however, the impossibility of comparing the findings poses limitations to answering the questions in this review.

CONCLUSIONS

Despite the heterogeneity of the studies, the narrative and tabular analysis demonstrated that short-term case management in primary care (six-month studies) helped to reduce blood pressure levels, although the level of evidence for these results is low or very low.

DECLÍNIO DAS TAXAS DE INTERNAÇÃO HOSPITALAR POR DOENÇAS CARDIOVASCULARES EM ADULTOS NO BRASIL

Objetivo: analisar a tendência das taxas de internação hospitalar por doenças cardiovasculares em adultos no Brasil.Método: estudo ecológico, de séries temporais, das taxas de internação por doenças cardiovasculares em adultos por sexo, faixa etária e região de residência no Brasil no período de 2005 a 2016. Foram utilizados os dados do Sistema de Informações Hospitalares do Sistema Único de Saúde. Para as análises de tendência, utilizaram-se modelos de regressão polinomial.Resultados: detectou-se tendência de declínio nas taxas de internação por doença cardiovascular em todo o país, sendo que a região Centro-Oeste obteve a redução mais expressiva (-21,29 ao ano). A região Sul deteve as maiores taxas de internação, inclusive por doenças isquêmicas do coração e cerebrovasculares.Conclusão: o Brasil apresentou tendência decrescente nas taxas de internação, entretanto, ainda são elevadas. Os resultados podem repercutir nas ações de vigilância em saúde, especialmente em regiões cujas taxas de internação apresentam-se elevadas.

Pandemia da COVID-19: repercussões no quotidiano da família de profissionais de saúde atuantes em unidades emergenciais

Resumo Objetivo compreender as repercussões da pandemia da COVID-19 no quotidiano de familiares de profissionais de saúde atuantes em unidades de emergência. Métodos estudo descritivo-exploratório de abordagem qualitativa, realizado com 18 familiares de profissionais de saúde atuantes em duas unidades de emergência localizadas no Sul do Brasil. Os dados foram coletados de setembro a novembro de 2020, mediante entrevistas telefônicas audiogravadas, posteriormente transcritas na íntegra. A análise foi realizada à luz da sociologia compreensiva. Resultados as repercussões negativas da pandemia no quotidiano dos familiares foram marcadas pelo medo da atuação profissional na linha de frente e pela possibilidade de o familiar se contaminar, levando, por conseguinte, o vírus para os demais membros da família. Porém, paradoxalmente, houve repercussões positivas, como a união dos membros da família e maior aproximação da religiosidade/espiritualidade. Considerações finais e implicações para a prática identifica-se como relevante o desenvolvimento de estratégias de comunicação para oferecer suporte emocional, promover encorajamento, reconhecimento das forças do sistema familiar e, se necessário, educação para que se diminuam as consequências negativas, como o estigma e as desavenças decorrentes dessa experiência.

Uso de psicotrópicos por pessoas idosas com hipertensão: prevalência e fatores associados

Resumo Objetivo analisar os fatores associados ao uso de psicotrópicos por pessoas idosas com hipertensão arterial (HA) acompanhadas pela atenção primária. Método estudo transversal, realizado em um município do noroeste do estado do Paraná, Brasil. A coleta de dados foi realizada com pessoas idosas, no primeiro semestre de 2016, por intermédio de um instrumento adaptado e validado para avaliação da satisfação com os serviços da Atenção Primária à Saúde. Utilizou-se o modelo de regressão logística, com o método stepwise e a magnitude das associações foi estimada pelo cálculo de Razão de Prevalência (RP). Resultados participaram do estudo 260 pessoas idosas com HA, das quais 25,4% faziam uso de psicotrópicos, sendo a maioria com idade entre 60 e 69 anos (48,8%) e do sexo feminino (67,3%). A análise multivariada evidenciou que o uso de psicotrópicos é mais prevalente em idosos que fazem uso de tabaco (RP: 4,09; IC95%: 1,81–9,18), com circunferência abdominal alterada (RP: 2,58; IC95%: 1,29–5,18), com obesidade (RP: 2,43; IC95%: 1,30–4,55) e aos que relataram ter efeitos colaterais dos medicamentos utilizados no tratamento da HA (RP: 2,98; IC95%: 1,23–7,21). No contexto organizacional e relacionais das equipes da estratégia saúde da família, em idosos com hipertensão e que fazem uso de psicotrópicos observou-se maior prevalência na insatisfação com o atendimento (RP: 6,71; IC95%: 1,37–32,71) e com a falta de apoio e de compreensão com os problemas relatados durante as consultas (RP: 2,17; IC95%: 1,11–4,25). Conclusões Por ser um problema de saúde pública e que atinge parcela significativa da população com maior risco de agravos à saúde, destaca-se a importância de pesquisas nessa área, as quais busquem alternativas para melhorar a qualidade de vida da pessoa idosa com comorbidades e que utilizam psicotrópicos por meio de um cuidado integral.

EDUCATIONAL INTERVENTION TO INCREASE THE SKILL OF INFORMAL CAREGIVERS: A QUASI-EXPERIMENTAL PILOT STUDY

ABSTRACT Objective to compare the skill of informal caregivers to care for dependent people undergoing educational planning discharge intervention with and without follow-up at home. Method this is a quasi-experimental, randomized, simple pilot study, with pre and post-test, not blind, however, with blind assessment of the outcomes, with two follow-up interventions. It was carried out between October 2019 and January 2020 in Maringá, Brazil, with 21 informal caregivers of dependent people, randomized to Intervention Group I and Intervention Group II. Group I underwent an educational intervention consisting of guidance and training during the hospitalization period, with follow-up after hospital discharge by nurses at home, and participants in Group II received only guidance at the hospital. To assess the difference in the level of skill, the COPER 14 instrument was used, applied at times 0, week 1 and week 4, submitting the results to analysis of variance. Results group I had more than twice as much (mean score=8.94) of skill as Group II (mean score=3.90), with a significant increase in practically all the variables analyzed. A significant increase in the score ranks was detected between the variables cognitive and behavioral skill (1.19 - 3.00, p=0.001), psychomotor (1.13 - 3.00, p=0.001) and relational (1.75 - 2.75, p=0.037) in Group I. Conclusion the educational intervention given to the Intervention Group I (IG-I) was effective in increasing the skill of informal caregivers of dependent people. Brazilian Registry of Clinical Trials RBR-5rzmzf.

Factors associated with the use of potentially inappropriate medications by elderly people with hypertension

OBJECTIVE

to analyze factors associated with the use of potentially inappropriate medications by elderly people with hypertension.

METHOD

a cross-sectional study, conducted in the first semester of 2016, with elderly people undergoing treatment for hypertension, living in the city of Maringá. Interviews, medical records analysis, and measurement of clinical and anthropometric parameters of the participants were carried out. Inferential analysis was used.

RESULTS

a total of 260 elderly people who used potentially inappropriate medications participated in the study. The high use of these medications was associated with clinical and anthropometric conditions, such as obesity (p=0.022), smoking (p=0.004), polypharmacy (p=0.034) and the health services provided, such as organizationally accessible treatment (p=0.027) and consultation time (p=0.007), predisposing to low adherence to routine consultations (p=0.003).

CONCLUSION

it was shown that the factors associated with the use of potentially inappropriate medications were associated with anthropometric, clinical, and organizational variables, intrinsic to the family health strategy.

Guidelines to the families of mental health service users from the multi-professional team's perspective

OBJECTIVE

to apprehend the guidelines provided by the interdisciplinary team to the user's family member at a Centro de Atenção Psicossocial Álcool e Drogas (Psychosocial Care Center for Alcohol and Drugs).

METHODS

descriptive-exploratory study, with a qualitative approach, carried out in a Psychosocial Care Center for alcohol and drugs in the southern region of Brazil, using the Psychiatric Reform as a conceptual basis. Data collection took place from June to August of 2019 through semi-structured interviews with a multidisciplinary team. The data were organized and operationalized in the IRAMUTEQ® software, and submitted to content analysis, thematic modality.

RESULTS

two classes emerged: "Guidelines referring to moments of crisis and the family members' arrival to the service" and "Difficult factors and strategies to enhance the guidance to family members".

FINAL CONSIDERATIONS

The guidelines focus on pathology and the service itself. Participants highlighted embracement, the group for families, qualified listening, and cooperation with primary care as ways to enhance the service to families.

Effect of sleeve gastrectomy on lipid parameters and cardiometabolic risk in young women

OBJECTIVE

to analyze the effect of vertical gastrectomy on lipid profile and cardiometabolic risk in young women, preoperatively and 6 months after the operation.

METHODS

retrospective study, encompassing medical record reviews of women's charts, preoperatively and in six months after the operation. Data collection was performed in the second half of 2015, using a review protocol with questions on the clinical-laboratory profile, anthropometric and laboratory classification of dyslipidemias. Descriptive and inferential analysis were used to treat the variables, using measures of variance, association and linear regression.

RESULTS

we analyzed medical records of 114 women undergoing vertical gastrectomy, with a mean age of 33.82±10.92, and with complete high school education. There was a significant reduction of anthropometric data, as well as serum lipid values, six months after the surgical procedure. The coefficients of determination and the results of linear regression, showed that the reduction in serum triglyceride values and increase in high-density lipoprotein have a direct impact on the reduction of the cardiometabolic risk. Regarding the laboratory classification of dyslipidemias, it was observed that the majority presented a significant reduction at the six-month follow-up. Mixed hyperlipidemia showed no significant reduction. The categorized cardiometabolic risk showed a significant reduction in women at risk before vertical gastrectomy.

CONCLUSION

at the six-month follow-up, vertical gastrectomy was effective in reducing the serum lipid profile and the cardiometabolic risk of young women when compared to the preoperative data. There was also a different improvement in the laboratory classification of dyslipidemias at the six-month follow-up after the surgical procedure.

Mental health of healthcare professionals in China during the new coronavirus pandemic: an integrative review

OBJECTIVE

to identify publishing related to the mental health of health professionals working in the front line of the COVID-19 pandemic.

METHODS

an integrative review that included primary articles indexed in the Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Science Direct databases and US National Library of Medicine databases. The result analysis was performed descriptively, in four analytical categories.

RESULTS

The publishing involved aspects related to insufficient personal protective equipment, feelings of fear and stigma, the need for psychological and psychiatric support and the possibility of post-outbreak mental disorders.

CONCLUSION

All mentioned aspects have a direct impact on the mental health of professionals, demanding the creation of strategies that minimize the emotional burnout of workers, considering that each country and culture reacts differently to the disease.

Participation in the coexistence center for elderly: repercussions and challenges

OBJECTIVE

To analyze the repercussions on the life of the elderly after joining a coexistence center and the existing challenges from the perspective of the participants and their families.

METHODS

Qualitative research conducted with 16 elderly from a coexistence center and 14 family members. Data were collected through individual interviews and subjected to content analysis.

RESULTS

Two thematic categories were identified: "Before and after: changes in the life of the elderly after joining the coexistence center" and "Aspects needed to improve care in the coexistence center". Final Considerations: The benefits of older people's participation in the service are evidenced by changes in lifestyle and interrelationships. However, there is a need to expand assistance in these institutions, with a multidisciplinary team trained in gerontogeriatric care, as well as to consider the importance of nursing as a science of care and insert it in this service.

Conicity index in people with hypertension followed in the Brazil's Family Health Strategy

OBJECTIVES

to analyze the conicity index in people with hypertension followed in the Brazil's Family Health Strategy.

METHODS

cross-sectional study conducted in a medium-sized municipality located in the state of Paraná. Data collection took place in the first semester of 2016. using an adapted and validated instrument. which addresses attributes of Primary Health Care. Sociodemographic and anthropometric variables and blood pressure were used in the study. The analysis of variance and linear regression was used to analyze the variables.

RESULTS

a total of 417 people participated in the study. most were women. elderly. married. with less than eight years of education and retired. Conicity index was prevalent in most of the study population. being significantly associated with the group of people with inadequate blood pressure control and high anthropometric parameters.

CONCLUSIONS

most of the study participants had altered conicity index. especially those with inadequate blood pressure control.

Diabetes mellitus e saúde bucal: a complexa relação desta assistência na atenção primária à saúde

Avaliar como os profissionais da Atenção Primária desenvolvem a assistência para a prevenção das complicações bucais nas pessoas com diabetes. Trata-se de uma pesquisa avaliativa qualitativa, que teve como referencial teórico o pensamento complexo. Participaram 29 integrantes da Estratégia Saúde da Família. Utilizaram-se três técnicas de coleta de dados: entrevista, observação e análise a prontuários. Para a análise adotou-se a triangulação de dados, as etapas analíticas da Grounded Theory e a análise dirigida aos protocolos do Ministério da Saúde; com auxílio do software ATLAS.ti. Os profissionais desconheciam os problemas bucais, enquanto complicação crônica do diabetes; o encaminhamento para a odontologia ocorria mediante a queixa, sem referência a tratamento preventivo; e, o trabalho interdisciplinar encontrava-se desarticulado da atenção que visa a totalidade das pessoas com diabetes. A prevenção da saúde bucal nessa população apresentou grande divergência do estabelecido pelo Ministério da Saúde.

Enfoque familiar e comunitário da Atenção Primária à Saúde a pessoas com Hipertensão Arterial

RESUMO A Hipertensão Arterial é uma morbidade crônica de alta prevalência no mundo. Nesse prisma, é importante conhecer o impacto da assistência prestada pelos profissionais, no contexto da Atenção Primária à Saúde, para compreensão e formulação de novas estratégias de atendimento. Este estudo objetivou analisar o enfoque familiar e comunitário da Atenção Primária à Saúde a pessoas com Hipertensão Arterial. Trata-se de um estudo transversal, realizado com 417 pessoas em tratamento da Hipertensão Arterial de 34 Unidades Básicas de Saúde do município de Maringá, localizado no noroeste do estado do Paraná, Brasil. Os dados foram coletados no primeiro semestre de 2016, utilizando instrumento adaptado e validado, que aborda atributos da Atenção Primária à Saúde, sendo utilizado, neste estudo, o atributo enfoque familiar e comunitário. Para tratamento das variáveis, foi utilizada análise inferencial. Foi possível observar que os atributos referentes ao envolvimento familiar no tratamento, incentivo à participação social na comunidade e realização de educação em saúde foram os quesitos com pior avaliação, sendo representados estatisticamente por pessoas com controle pressórico inadequado. Conclui-se que a atenção quanto ao enfoque familiar e comunitário possui fragilidades e que necessitam ser reavaliadas, integrando a família e a comunidade no tratamento de pessoas com Hipertensão Arterial.

Necessidades dos cuidadores de pacientes vítimas de Acidente Vascular Encefálico após a alta hospitalar

Objetivou-se descrever as necessidades dos cuidadores familiares de pessoas vítimas de acidente vascular encefálico após a alta hospitalar. Pesquisa qualitativa do tipo convergente assistencial, realizada com quatro famílias e operacionalizada por visitas domiciliares de acordo com a necessidade de cada família. Os dados foram coletados por meio de entrevistas abertas e observação participante, transcritos e submetidos à análise de conteúdo, modalidade temática. Os achados foram organizados em duas categorias temáticas, sendo elas: Descobrindo a necessidade de dar continuidade ao tratamento do familiar em casa e; O apoio social à família no enfrentamento do adoecimento.A partir da realidade observada, foi possível identificar dificuldades e orientar as famílias no domicílio, auxiliando-as em suas adaptações logo após alta hospitalar, além de promover a recuperação da pessoa adoecida e a qualidade de vida do cuidador familiar.

Adherence of hypertension patients in the Brazil's Family Health Strategy

OBJECTIVE

to evaluate the adherence and associate it to blood pressure control and to follow-up observation of people with hypertension in the Brazil's Family Health Strategy.

METHOD

cross-sectional study, conducted with 417 people in treatment of hypertension, living in a municipality located in the Northwest region of the state of Paraná, Brazil. The data were collected in the first 2016 semester, using an instrument adapted and validated for the evaluation of satisfaction with the services offered by Primary Health Care. Analysis of variance and the logistic regression model were used for the treatment of variables.

RESULTS

it was evidenced that people with inadequate follow-up observation evaluate the relations between professional/user and the guidance to the medications used as unsatisfactory.

CONCLUSION

weak guidelines and ineffective dialogue between health professionals and users might result in an inadequate follow-up observation of blood pressure control and of people with hypertension.

MORTALIDADE POR DOENÇAS CARDIOVASCULARES NO ESTADO DO PARANÁ

Objetivo: analisar a tendência da mortalidade por doenças cardiovasculares isquêmicas e cerebrovasculares, segundo faixa etária e sexo no estado do Paraná. Metodologia: estudo ecológico das taxas de mortalidade por doenças cardiovasculares nos anos 2000 a 2014, realizado no mês de julho de 2016. Utilizou-se o modelo de regressão polinomial para a tendência. Resultados: houve aumento progressivo das taxas de mortalidade com o aumento da idade em ambos os sexos. No primeiro triênio, 2000 a 2002, as taxas se mostraram mais elevadas, com exceção das doenças cerebrovasculares em homens de 20 a 29 anos e doenças isquêmicas em mulheres nessa mesma faixa etária. Conclusão: diante do elevado número de óbitos por doenças cardiovasculares no estado, com tendência de crescimento da mortalidade por doenças cerebrovasculares na população masculina jovem, evidencia-se a necessidade da intensificação do trabalho da Enfermagem, nos diversos níveis de atenção, para o combate aos fatores de risco nessa população.

Acessibilidade ao tratamento da hipertensão arterial na estratégia saúde da família

Resumo OBJETIVO Analisar a satisfação acerca da acessibilidade ao tratamento de pessoas com hipertensão arterial acompanhadas pela Estratégia Saúde da Família. MÉTODO Estudo transversal, realizado com 417 pessoas residentes em um município do estado do Paraná, Brasil. A coleta de dados foi realizada entre fevereiro a junho de 2016, utilizando instrumento de satisfação com serviços prestados pela Atenção Primária à Saúde, empregando questões referentes a acessibilidade ao tratamento. Adotou-se análise descritiva e inferencial para tratamento das variáveis. RESULTADOS Participaram do estudo 417 pessoas, em que 62,4% era idoso, 67,8% do sexo feminino e 55,2% era aposentado/pensionista. A acessibilidade econômica foi o indicador melhor avaliado. A avaliação regular dos serviços característicos da acessibilidade geográfica e organizacional foi significantemente associada ao acompanhamento inadequado desses usuários na Estratégia Saúde da Família. CONCLUSÃO Os serviços ofertados às pessoas com hipertensão arterial foram avaliados como regular, apresentando principais barreiras referente a aspectos geográficos e organizacionais.

Effectiveness of case management performed by nurses for blood pressure control in adults with hypertension: a systematic review protocol

REVIEW QUESTION/OBJECTIVE

The question of this review is: what is the effectiveness of nurse case management in primary healthcare for improving blood pressure, in adults over 18 years with hypertension?The objective of this review is to synthesize the best available evidence regarding the effectiveness of nurse case management in primary healthcare, compared to usual care, in improving blood pressure in adults over 18 years with hypertension.

Analysis of obese patients' medical conditions in the pre and postoperative periods of bariatric surgery

Objective

to compare the clinical conditions of obese patients in the pre and postoperative period of bariatric surgery.

Methods

we carried out a descriptive, retrospective, quantitative study by consulting the charts of 134 patients who underwent bariatric surgery in the period from 2009 to 2014. We collected the data between September and November 2015. We performed a descriptive statistical analysis and comparative analysis of anthropometric, metabolic, biochemical and clinical variables, considering six months before and after surgery.

Results

the majority of the patients were female (91.8%), with a higher prevalence (35%) in the age group 18-29 years old, complete high-school education (65.6%) and grade III obesity (60.4%). Six months after surgery, weight and lipid profile reduction were significant in both genders, but the impact on biochemical, anthropometric, metabolic and clinical parameters was significant only in female subjects, with a reduction in morbidities associated with obesity, such as arterial hypertension, diabetes mellitus, dyslipidemia and metabolic syndrome and in the use of drugs to control them.

Conclusion

bariatric surgery was effective in weight loss, with improvements in anthropometric, metabolic and biochemical parameters and in the reduction of morbidities associated with obesity.

FATORES ASSOCIADOS À PRESSÃO ARTERIAL INADEQUADA DE PESSOAS COM HIPERTENSÃO

Objetivo: avaliar os fatores associados à pressão arterial inadequada em pessoas com hipertensão acompanhadas pela Estratégia Saúde da Família. Método: estudo transversal, realizado com 417 pessoas, no município de Maringá, Paraná. A coleta de dados foi realizada no primeiro semestre de 2016, por meio do instrumento satisfação do usuário com hipertensão arterial com os serviços prestados pela Atenção Primária à Saúde, utilizando as questões referentes ao perfil sociodemográfico, nutricional e clínico. Na análise dos dados, aplicou-se estatística descritiva e inferencial. Resultados: a maioria dos entrevistados, 62,4% era idoso, 67,8% do sexo feminino e 55,2% aposentado/pensionista. Houve associação da pressão arterial inadequada com pessoas de idade superior a 59 anos, aposentados/pensionistas, moderadamente ativos, não praticantes de atividades físicas e fragilidade nas orientações sobre a doença. Conclusão: os resultados sinalizam a necessidade de reorganização do processo de trabalho, com o fortalecimento das orientações e educação em saúde às pessoas com hipertensão arterial.