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.