DSpace Coleção:https://repositorio.ufms.br/handle/123456789/19772024-03-28T10:23:28Z2024-03-28T10:23:28ZTENDÊNCIA TEMPORAL, E DISTRIBUIÇÃO ESPACIAL E LETALIDADE DA COINFECÇÃO LEISHMANIOSE VISCERAL E HIV EM MATO GROSSO DO SULhttps://repositorio.ufms.br/handle/123456789/85992024-03-26T13:24:40Z2024-01-01T00:00:00ZTítulo: TENDÊNCIA TEMPORAL, E DISTRIBUIÇÃO ESPACIAL E LETALIDADE DA COINFECÇÃO LEISHMANIOSE VISCERAL E HIV EM MATO GROSSO DO SUL
Abstract: Visceral leishmaniasis and HIV/AIDS co-infection constitutes a serious public health problem
due to its magnitude and economic and social impact. In the Brazilian scenario, the state of
Mato Grosso do Sul is characterized as an endemic region for leishmaniasis and, in recent years,
has shown an increasing trend in HIV cases, which makes it necessary to develop studies on coinfection.
Thus, the objective of this study was to analyze the temporal trend, spatial distribution
and lethality of visceral leishmaniasis and HIV/AIDS co-infection cases. Descriptive, crosssectional
and quantitative study, carried out based on notifications of visceral leishmaniasis
cases in the state of Mato Grosso do Sul in the period 2012-2022. Notifications from the
Notifiable Diseases Information System were used, which were made available by the State
Department of Health, after approval by the Research Ethics Committee of the Federal
University of Mato Grosso do Sul. Data were analyzed using descriptive statistics and thematic
mapping. During the period under study, 1,881 cases of visceral leishmaniasis were reported,
of which 1,594 were confirmed and 319 (20.01%) had VL-HIV/AIDS co-infection, with the
highest incidences in: Rio Negro, Rio Verde de Mato Grosso, Porto Murtinho and Anastácio.
The temporal trend of visceral leishmaniasis and HIV/AIDS co-infection cases remained stable.
Although there was no statistical evidence of a spatial pattern in incidence, there was
considerable geographic expansion in the North Central Region of the state. The comparison of
VL lethality with VL-HIV/AIDS co-infection had no significant difference. There was a
statistical association between individuals over 40 years of age and a higher probability of death
(p-value=0.032; OR: 0.40). The results found offer support for reflection on the work process
of health teams and zoonosis services in the state, as well as elucidating the need for strategic
actions to prevent the diseases in question, screening and early diagnosis, in addition to vector
control strategies, which must take into account the climatic and geographic characteristics and
the availability of health services in the area. Furthermore, special attention should be paid to
individuals over 40 years of age, as they have a higher risk of mortality.
Keywords:Visceral leishmaniasis; Coinfection; HIV. Disease notification; Public Health
Nursing. Nursing
Tipo: Dissertação2024-01-01T00:00:00ZCULTURA DE SEGURANÇA E CARGA DE TRABALHO DE PROFISSIONAIS DA ATENÇÃO PRIMÁRIA À SAÚDEhttps://repositorio.ufms.br/handle/123456789/82792024-01-18T12:00:41Z2023-01-01T00:00:00ZTítulo: CULTURA DE SEGURANÇA E CARGA DE TRABALHO DE PROFISSIONAIS DA ATENÇÃO PRIMÁRIA À SAÚDE
Abstract: Ensuring patient safety in the Health Care Network involves establishing a culture that
values safety and the recognition that workload can interfere with professionals’ perception
and attitudes. Faced with a scenario in which Primary Health Care is little covered by
official documents and scientific literature on patient safety, this research aimed to analyze
the relationship between safety culture and the workload of Primary Health Care
professionals. This was an exploratory study, typified as Survey, with a quantitative
approach, carried out from January to July 2023, with 355 Primary Care professionals from
a capital in the Center- West of Brazil. Three instruments were used: the worker’s
sociodemographic characterization questionnaire; the National Aeronautics and Space
Administration – Task Load Index method and the Medical Office Survey on Patient Safety
Culture instrument, the latter two having been validated and adapted to the Brazilian reality.
The data were subjected to descriptive and inferential statistical analysis. Data collection
initially took place electronically; however, from May onwards, it was conducted in person
until the sample was obtained. A total of 355 professionals from different categories took
part, including nurses (n=112, 31.5%), community health and endemic disease control
agents (n=62, 17.8%) and dentists (n=40, 11.3%) who had been working in the network for
less than five years (44.8%, n=159). The workload was considered high by most
professionals (73.8%), and the 12 dimensions of the Medical Office Survey on Patient
Safety Culture instrument were evaluated with scores lower than 75%, being considered
fragile dimensions of safety culture. The best rated dimension was ‘Patient care follow-up’,
with 63.7% (n=214), followed by ‘Teamwork’, with 60.3% (n=214). It was observed that
‘Open communication’ and ‘Communication about errors’ were more positive among
administrative professionals compared to health care professionals (54.10% x 45.50%;
55.90% x 42.90%, respectively). The worst rated dimension was ‘Pressure and pace of
work’, with 18.6% (n=66). There was a significant statistical association between a higher
prevalence of positive answers and a weekly workload of up to 40 hours in the dimensions
‘Support from managers in patient safety’ (p<0.0001) and ‘Issues related to patient safety
and quality’ (p<0.0001) p<0.0001). Furthermore, an association was found between a lower
workload and a better evaluation of safety culture in the dimensions ‘Work process and
standardization’ (p-value=0.01) and ‘Support from managers in patient safety' (p value=0.03), as well as in the General safety and quality evaluation. It is concluded that
there was an association between high workload and a worse perception of patient safety
culture among primary care professionals. In this way, explaining the unfavorable
conditions for the perception of safety culture in primary care can support the planning of
actions focused on reviewing work processes and, consequently, advance in terms of safety
culture in primary care, a scenario that has been little explored in this area, thus enhancing
the scientific dissemination of the challenges faced by primary health care workers.
Tipo: Dissertação2023-01-01T00:00:00ZCONHECIMENTO DOS AGENTES COMUNITÁRIOS DE SAÚDE SOBRE ACIDENTE VASCULAR CEREBRAL: ESTUDO METODOLÓGICO E TRANSVERSALhttps://repositorio.ufms.br/handle/123456789/82382023-12-29T16:49:11Z2023-01-01T00:00:00ZTítulo: CONHECIMENTO DOS AGENTES COMUNITÁRIOS DE SAÚDE SOBRE ACIDENTE VASCULAR CEREBRAL: ESTUDO METODOLÓGICO E TRANSVERSAL
Abstract: Stroke – Cerebrovascular accident (CVA) leads among the main causes of death in Brazil and
ranks second worldwide. Not knowing its acute signs can delay care and undermine the
patient’s prognosis. Informing the population about these signs is crucial, and community
health workers (CHW) are an effective strategy for disseminating this information and
promoting quick actions in urgent situations. The objective of this research is to measure the
knowledge of CHW about prevention, acute signs, and symptoms, and the first actions in
emergency situations due to CVA. The study was developed in two design stages:
methodological and cross-sectional. The methodological phase aimed to build and validate an
instrument to assess CHW’s knowledge about CVA. In the first phase, an integrative literature
review was carried out and then the opinion of experts in the study area was consulted. In the
second, content validation was carried out using the Delphi technique. In the third, the pre-test
was applied to the target population for face validation, assessing clarity, comprehensibility,
and completion time. Data analysis was performed using agreement analysis and content
validity index (CVI). The cross-sectional study consisted of applying a validated questionnaire
in 16 health units, which was answered by 235 CHW and sought to answer the central question
of the study. Pearson’s Chi-square test was used for categorical variables. For continuous
variables, the Mann-Whitney (U) and Kruskal-Wallis tests were used. In the cross-sectional
study, women predominated, most CHW declared themselves as brown/yellow, aged 40-49
years, mean age of 44.49 ± 8.55. More than 80% had worked as CHW for more than five years,
50% of whom had primary education and 66.4% had no health training. Knowledge ranged
from poor (36.2%), bad (29.8%), regular (13.2%), good (17.9%), very good (2.1%) and
excellent (0.9%). Married people, with higher education, health training and less than five years
working as CHW, and workplace showed a higher number of correct answers. Having training
in the health area is related to lower scores in "poor" and higher scores in "very good" (p=0.03).
Having a higher education degree was associated with higher scores in "good", while only
primary/secondary education was associated with higher scores in "poor" (p=0.03).
Professionals with more than five years working as CHW had lower scores in "good" and higher
scores in "poor" (p<0.001). The percentage of correct answers given by CHW in relation to the
length of time they have been in post shows an inverse trend: those with more than five years
in their posts have higher scores in negative categories, while those with less than five years
have more correct answers in "bad", "regular" and "good ". Family income of four minimum
wages was associated with more correct answers for "good" and less for "poor" (p=0.02). The
validated questionnaire showed insufficient knowledge of CHW about CVA. In the treatment
session, the lowest scores prevailed. The need for continuing education should be highlighted,
emphasizing the identified gaps. It is recommended to promote discussions about public
policies and health training, with a view to reinforcing knowledge in the studied population.
Tipo: Dissertação2023-01-01T00:00:00ZCONSTRUÇÃO E VALIDAÇÃO DE CONTEÚDO E SEMÂNTICA DA ESCALA DE PERCEPÇÃO DE AUTOEFICÁCIA DA FAMÍLIA NO CUIDADO DOMICILIAR DA CRIANÇA EM DIÁLISE PERITONEALhttps://repositorio.ufms.br/handle/123456789/81672023-12-13T19:38:24Z2020-06-04T00:00:00ZTítulo: CONSTRUÇÃO E VALIDAÇÃO DE CONTEÚDO E SEMÂNTICA DA ESCALA DE PERCEPÇÃO DE AUTOEFICÁCIA DA FAMÍLIA NO CUIDADO DOMICILIAR DA CRIANÇA EM DIÁLISE PERITONEAL
Abstract: The daily life of children on peritoneal dialysis is characterized by hospitalizations, use of catheters, diet control, medication management and exhaustive care, which requires the family's participation, involvement, availability and abilities to manage the care of the child with this chronic condition at home. It is questioned how the family perceives its own self
efficacy, considering that this perception is a key / fundamental to get to know the family's efforts to fulfill the assigned task and perseverance in the face of difficult situations. In the literature there is no scale available that permits identifying the perceived self-efficacy of the family in this situation. Objective. To perform the content and semantics validation of an instrument that may measure the family self-efficacy for the home-based care of children on peritoneal dialysis. Method. A methodological study was conducted that adopted the model proposed by Pasquali to guide the construction and validation of the instrument. Bandura's Theory of Self-efficacy was the theoretical framework that underpinned the construction of the scale. The theoretical procedures were conducted in three stages: (a) definition of the construct by means of literature review and field study; (b) content validation; and (c) semantics validation. The interjudge agreement percentage of 80% and the Content Validity Index of 0.8 were established, and the Kappa Index was applied. The study was carried out in the pediatric nephrology outpatient unit of a school hospital, after approval by the UFMS Ethics and Research Committee. Results. The proposition of the scale items was supported by the analytical synthesis of the categories identified in the scoping review and in the field study with families of children on peritoneal dialysis at home. The content validation was carried out by five experts in the concept field, using the Delphi technique, and yielded a Content Validity Index of 0.84 after three rounds, and total Kappa of 0.70, showing good agreement among the experts. Five families of children undergoing dialysis treatment at home participated in the semantics validation, after two rounds, with 100% agreement and reports of good understanding of the items. The constructed scale contains 26 items that explore the perception of the collective effectiveness of the family in this context of care. The responses are scaled from zero to 100, distributed along a continuum of no confidence, moderate confidence and total confidence. Conclusion. The scale is a tool to identify the perceived collective efficacy of the family, that is, the care behaviors that the family feels capable of performing to meet the home-based care the child´s and the family´s demands in the face of difficulties. The instrument can be useful in helping nurses identify the family's strengths and vulnerabilities and plan actions together, contributing to better care practices. Continuing the development of the scale is recommended with the conduction of the empirical and analytical phases for carrying out the psychometric tests.
Tipo: Dissertação2020-06-04T00:00:00Z