Dissertações em Enfermagem (Mestrado) - PPGENF/ICS

URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/4815

O Mestrado Acadêmico iniciou-se 01/01/2011 pertence ao Programa de Pós-Graduação em Enfermagem (PPGENF) do Instituto de Ciências da Saúde (ICS) da Universidade Federal do Pará (UFPA).

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Análise espacial da epidemia de HIV entre homens jovens no Brasil: um estudo ecológico
(Universidade Federal do Pará, 2023-08-21) MARTINS, Cleyton Abreu; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530
Introduction: Globally, it is estimated that for every seven new human immunodeficiency virus (HIV) infections, two occur among young people. Spatial analysis studies are essential tools in the fight against HIV. Objective: To spatially analyze the Brazilian historical scenario of the HIV epidemic among young men, from 2007 to 2021. Methods: An ecological study that used secondary databases from the Notifiable Diseases Information System. All cases of HIV and immunologically acquired disease syndrome (AIDS) among men between 15 and 29 years of age and with fixed residence in Brazil were considered. The 5,570 Brazilian municipalities were considered as the unit of analysis and the HIV/AIDS incidence rate standardized by age group as a variable. The following spatial analysis techniques were used: 1) Spatial Distribution, 2) Spatial Autocorrelation and 3) Spatial Scan. Results: 108,392 cases of HIV were reported in Brazil among young men during the study period. The Southeast Region had the highest incidence rates, followed by the Northeast, South, North and Midwest regions. The HIV epidemic showed territorial expansion in all Brazilian regions, with the exception of the southern region, which contracted. Although there has been a decrease in the number of hotspots in all regions, in the North and Northeast regions there has been an expansion in the size of hotspots. There was no expansion of coldspots in the regions. The space-time risk zones were comprised between 2015 and 2021 and all were formed by state capitals and surrounding municipalities. Conclusion: The different behaviors of the HIV epidemic in Brazilian regions may be associated with different regional sociopolitical scenarios. The consolidation, expansion and emergence of new hotspots point to locations where the fight against HIV among young people should be strengthened. The space-time risk analysis shows that the highest HIV detection rates occur in municipalities with higher demographic densities, and the long time period suggests fragility in policies to combat the virus. For the elimination of HIV, greater integration of municipalities, states and the federal government is necessary in the search for greater social equity.
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Análise espacial da epidemia do HIV entre mulheres brasileiras
(Universidade Federal do Pará, 2023-05-25) BEZERRA, Ana Luisa Lemos; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530
INTRODUCTION: The detection rate of Human Immunodeficiency Virus (HIV) among women has been decreasing in recent years. However, an epidemiological diagnosis at the national level is necessary to detail this behavior of the epidemic in this population, since the Acquired Immunodeficiency Syndrome (AIDS) remains the main cause of mortality among women aged 15 to 49 years. OBJECTIVE: To spatially analyze the historical scenario of the HIV epidemic in Brazil, among women from 15 years of age, from 2007 to 2020. METHODOLOGICAL DESIGN: Ecological study that used secondary databases of the Information System of Notifiable Diseases considering as unit of analysis the 5,570 Brazilian municipalities. All cases of HIV and AIDS among women living in Brazil were considered. The following spatial analysis techniques were used: 1) Spatial Distribution, 2) Spatial Autocorrelation and 3) Spatio-temporal risk analysis. RESULTS: There was a territorial decrease in the HIV epidemic throughout Brazil, but less decrease in the North, Northeast and Midwest regions. There was a decrease in the number of hotspost clusters (neighboring municipalities with a high incidence rate) throughout Brazil. However, some consolidated with expansion or contraction. Bahia, Paraná and Piauí were the only Brazilian states with coldspot clusters (neighboring municipalities with a low incidence rate), with Piauí standing out with the greatest expansion of this grouping. The South and Southeast regions presented spatio-temporal risks earlier than the other regions and all risk zones had in their compositions state capitals and most of them included adjacent municipalities. CONCLUSION: Although cluster hotspots have decreased in number, others have consolidated and new hotspots have also emerged. This study provides subsidies for the implementation of more effective and focused public policies to combat HIV among Brazilian women. There is a need to include municipal and state authorities in the planning of policies against HIV, always respecting the regional characteristics and each Brazilian municipality.
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Análise espacial e espaço-temporal dos casos de feminicídio ocorridos no estado do Pará entre 2016 e 2021
(Universidade Federal do Pará, 2023-10-27) SILVA, Ana Karoline Souza da; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530; LIMA, Vera Lúcia de Azevedo; http://lattes.cnpq.br/5247917929280755; https://orcid.org/0000-0003-0094-4530
INTRODUCTION: Feminicide is a public health problem worldwide, with Brazil occupying the 5th position among the countries that kill the most. In order to combat feminicide, it is imperative to understand its association with social determinants of health, and spatial analysis is a fundamental tool for this. OBJECTIVE: To analyze the spatial and space-time scenario of the femicide rate and its relationship with the social determinants of health in the State of Pará between 2016 and 2021. METHODS: An ecological study using secondary data from the Integrated Public Security System (SISP-WEB). Gross municipal feminicide rates were analyzed using spatial distribution and autocorrelation (Gi statistic), temporal-spatial risk analysis, and geographically weighted spatial regression (GWR). RESULTS: During the study period, 339 cases of feminicide were reported in Pará. The spatial distribution of the feminicide rate during the study period showed a territorial expansion, with municipalities in the Metropolitan Region of Belém, Northeast, Southeast, and Southwest of Pará being the most affected areas. From 2016 to 2018, there was a high-high in feminicide rate (hotspot) formed by municipalities in the southeast and southwest of Pará, while between 2019 and 2021, there were two hotspots in the southeast and northeast. The spatio-temporal analysis revealed only one risk zone (RR=2.11; p<0.000) in the period from 2018 to 2020 that consisted of municipalities in the Metropolitan region of Belém, Northeast, Lower Amazonas, Southeast and Southwest of Pará. The GWR showed that the variability of the feminicide rate was associated with the DSS “youth homicide rate per 100,000 inhabitants”, “primary care coverage rate”, and “total high school pass rate”. CONCLUSION: To combat feminicide it is necessary to promote greater social equity, discuss gender equality in schools, and bring greater responsibility/qualification of health professionals in the Primary Health Care network for the early identification of signs of domestic violence as well as reporting to competent legal channels.
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Assistência pré-natal e puerpério no âmbito da atenção básica no Brasil
(Universidade Federal do Pará, 2023-07-10) SOUSA, Dimauro Soares de; RODRIGUES, Diego Pereira; http://lattes.cnpq.br/8470989067617455; https://orcid.org/0000-0001-8383-7663; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
Recognizing Primary Care as the preferential gateway to public health services and its role in organizing care, investigating prenatal and puerperal care is essential for measuring its reach and quality, in order to provide subsidies for making decisions based on the results. Objectives: To analyze prenatal and postpartum care within the scope of Primary Care in Brazil. Methodology: This is a research with a quantitative and analytical approach. Brazil is the reference for this study. The variables related to the External Evaluation of the third cycle of the National Program for Improving Access and Quality of Primary Care were used for the research, Module II – Interview with the professional, coordinated by the ministry of health, from 2017 to 2018, which includes interviews with key informants. Teams were categorized by federative units and geographic regions, and data analysis were done using descriptve statistics, using absolute and relative frequency. All analyzes were done in IBM SPSS Statistics Software, version 20.0, and presented in the form of charts, graphs and figures. Results: The collection of data for the External Assessment that make up the second phase of the third cycle of the National Program for Improving Access and Quality in Primary Care, had the adhesion of 5.324 cities (95,6%). A total of 38,865 primary care teams in Brazil were evaluated, of these 36.702 (98,30%) teams perform prenatal consultations, 35.771(97,50%) presente a document proving the prenatal consultation, 36.433 (99,3%) of the primary care teams use the pregant woman’s handbook to monitor the pregnat women and 34.096(92,90) of those teams have a copymirror of the pregnant women’s handbook, or another form with equivalent information, at the Basic Health Unit. Regarding to the actions carried out by the team to guarantee the postpartum consultation up to one week after the childbirth, all of the brazilian regions have low rates of consultation at special times, in which any day of the week, with 65.4% adherence in this aspect. Conclusion: The results suggest that there are differences in prenatal and puerperal care in Brazilian regions. These results can be useful for other studies and for strengthening reginal planning actions. For managerial practice, the assistance during the prenatal and postpartum period must be repeatedly discussed.
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Avaliação da implementação dos planos de contingência para enfrentamento da COVID-19 em hospitais universitários brasileiros
(Universidade Federal do Pará, 2023-06-06) SOUSA, Michele Monteiro; ALMEIDA, Deybson Borba de; http://lattes.cnpq.br/3390707163827574; https://orcid.org/0000-0002-2311-6204; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
The aim of this study was to evaluate the implementation of contingency plans to cope with COVID-19 in Brazilian university hospitals. Comprehensive qualitative qualitative study with semi-structured interviews applied to managers and workers of 8 federal educational institutions who participated in the construction, implementation and evaluation of contingency plans to cope with COVID-19. The textual content of the interviews was submitted to the N-vivo software. Data analysis was performed using Bardin's content analysis, and as a theoretical basis Donabedian's theory evaluating the triad structure, process and result. The profile of the 17 participants of the research was mostly female (76%), 59% are nurses and 23% act as health care managers and 23% as superintendents within the EBSERH. In the structural dimension, the lack of inputs, such as PPE and medicines, directly interfered in the effectiveness of contingency plans. It evidenced the historical demands of health professionals regarding working conditions. The results found in the dimension, structure and result evidenced the weaknesses of some university hospitals to meet the potential demand generated by the COVID-19 pandemic. This study demonstrated the importance of planning, preparing and updating guiding documents for hospital institutions, such as the contingency plan, aimed at coping with a public health emergency, as well as the need for integration between management, care, teaching and research services.
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Caracterização dos homicídios de crianças paraenses
(Universidade Federal do Pará, 2020-02-19) SILVA, Adria Vanessa da; LIMA, Vera Lúcia de Azevedo; http://lattes.cnpq.br/5247917929280755; https://orcid.org/0000-0003-0094-4530
INTRODUCTION: Homicide is an expression of interpersonal violence, it is from it that we can grasp the seriousness of the situation of violence perpetrated against children in the state of Pará. It represents the extreme of violence in a society and a serious conjecture of economic, social disorder , political and religious. A complex, multifactorial, heterogeneous phenomenon with an impact not only on quality, but also on people's life expectancy. The characteristics of these deaths can vary according to the victim's age, sex, color or race and other factors. OBJECTIVE: To characterize the homicides of children in the state of Pará. METHODOLOGY: Descriptive, retrospective study with a quantitative approach based on Epidemiology. The study was carried out based on the homicide data of children in the state of Pará, registered with the Assistant Secretary of Intelligence and Criminal Analysis, linked to the Secretary of Public Security of Pará, covering the period from January, 2014 to December, 2018. 77 occurrences resulting in homicide were identified. For data collection, the technique of descriptive analysis was used in order to highlight the characterization of victims and authors. RESULT: The profile of the victimized children and the aggressors found that the children's age range is from 0 to 11 years old incomplete, with the male gender prevailing and the highest percentage in the 18 to 24 age group, the highest percentage practiced by stepfathers, who practiced the act against the minor in his own residence. The feeling of hatred / revenge, followed by jealousy and ambition were the presumed causes that led the aggressor to commit the act, being the means used to consummate the fact the firearm. The ten municipalities in the state of Pará with the highest prevalence of homicides with children in this period was Belém, followed by Ananindeua, Itaituba, Altamira, Monte Alegre, Marabá, Salvaterra, Breu Branco, Xinguara and Marapanim. Recognizing the intensity of the victimization of children by homicide and its distribution in the municipalities of our state provides contributions for the State to encourage public policies in order to effectively protect and maintain the lives of children in situations of violence within the family.
Acesso aberto (Open Access)
Cartilha “Aprendendo melhor a cuidar de si” para o autocuidado do cuidador de adoecidos pelo câncer
(Universidade Federal do Pará, 2022-06-04) VALE, Jamil Michel Miranda do; SANTANA, Mary Elizabeth de; http://lattes.cnpq.br/6616236152960399; https://orcid.org/0000-0002-3629-8932; LIMA, Vera Lúcia de Azevedo; http://lattes.cnpq.br/5247917929280755; https://orcid.org/0000-0003-0094-4530
The objective of this study was to apply the booklet “Learning better to take care of yourself” to family caregivers of people sick with cancer in palliative oncology care, as well as to investigate the burden on family caregivers and to analyze the correlation between the booklet “Learning better to take care of themselves” with the burden of these family caregivers. This is a descriptive study with a quantitative approach, carried out at the Ophir Loyola Hospital Palliative Care Clinic, with 147 family caregivers, in the second half of 2020. For the collection, two instruments were used: (a). Form for the characterization of caregivers and appreciation of the booklet; (B). Zarit Overhead Scale Questionnaire - Burden Interview. The collected data were tabulated, interpreted, processed and analyzed using descriptive and inferential statistics in Microsoft Excel® 2019 spreadsheets, in order to consolidate the information related to the data collected. The built database was organized and analyzed using the Statistical Package for the Social Sciences software version 24.0 in Windows 10 environment, with the results presented in tables and discussed based on the scientific literature. As a result it was obtained in the sociodemographic data that the caregivers are children (67 – 45,6%), female (86 – 58,5%), living outside Belém or metropolitan region (85, 57.8%), have completed High School (63 – 42,9%), are married (74 – 50,3%), mostly housewives (57 – 38,8%) and self-employed (45 – 30,6%), Catholic (71 – 48,3%) and have no income (81 – 55,1%). The average age of caregivers is 40 years old. Being a caregiver was a family decision (65 – 44,2%), exercising full-time care (89 – 60,5%), within a period of 1 to 5 years (69 – 46,94%), and sharing care with someone (89 – 60,5%) usually the brother (58 – 39,5%). The educational technology, the booklet 'Learning better to take care of yourself', achieved 91% acceptability. Regarding the general burden of caregivers, the majority presented Moderate to Severe burden (104 – 70,7%) and there was insufficient evidence to conclude that any of the variable’s gender, age group, health problems or length of care have any statistically relevant relationship with Zarit score (p > 0,05). As a conclusion, the booklet 'Learning better to take care of yourself', obtained 91% acceptability from family caregivers, who presented moderate to severe overload; Through the analyses, it was demonstrated that the acceptance of the booklet has a weak and inverse correlation with the burden, that is, the greater the acceptance of the booklet, the lower the burden presented by the family caregiver (alternative hypothesis - H1) and the burden will not be underwent statistically significant influence of the variables gender, age group, health problems or length of care, in this specific public (null hypothesis - H0). From the scores obtained in the question “do you have a health problem”, pain on the coast and use of alcoholic beverages did not show statistically significant differences. Although the other problems and habits were statistically significant. The Booklet, as an educational technology, strengthens and subsidizes the nursing care practice, legitimizing the continuity of the walk directed towards the new future care perspectives.
Acesso aberto (Open Access)
A compreensão de diabéticos sobre as complicações com os pés e as implicações para o autocuidado
(Universidade Federal do Pará, 2013-10-30) PEREIRA, Odenilce Vieira; SANTANA, Mary Elizabeth de; http://lattes.cnpq.br/6616236152960399; https://orcid.org/0000-0002-3629-8932
The mellitus diabetes is a chronic disease that in recent years has contributed to the increased mortality in the world. The nurse stands out as a primary actor in diabetic care by performing nursing care at different levels of health care patient. The study aimed to describe the understanding of diabetic complications on his feet; identifying information submitted by nurses and examine factors that contribute to the incidence of vascular complications involving self-care. Descriptive qualitative research, developed in the months from May to July 2013, with thirty diabetic hospitalized at the University Hospital of Belém - Pará. Data were collected through semi-structured and subjected to thematic content analysis according to the model proposed by Bardin interview. All legal requirements have been rigorously considered. The study included seventeen women and thirteen men with a mean age of sixty . Most respondents had low level of education , ignorance and misinformation about diabetes which resulted in the realization of self-care. The data analysis allowed the learning of four core categories: discovery and control of diabetes, complications of diabetes and foot care; evidence that interfere with self-care of the feet; contributions of the healthcare team to practice self-care with their feet. The discussion was based on the theoretical framework that has supported the research and related theory of Orem Self Care. This research sought to emphasize inpatient hospital setting, as a characteristic for the curative treatment environment, however we believe that it can also be a place conducive to educational activities related to self-care and prevention for complications with the feet of diabetic patients.
Acesso aberto (Open Access)
Conhecimento de famílias ribeirinhas relacionado às infecções sexualmente transmissíveis
(Universidade Federal do Pará, 2022-08-26) LIMA, Nyvia Cristina dos Santos; CASTRO, Nádile Juliane Costa de; http://lattes.cnpq.br/2532971599666350; https://orcid.org/0000-0002-7675-5106
Introduction: Sexually Transmitted Infections are Public Health problems, due to their magnitude and difficulty in accessing adequate treatment. Considering the magnitude and consequences of STIs for the world, it is important to provide and develop studies that allow researchers and managers of public policies and social investments to outline specific, solid and long-term strategies for the transformation of behaviors. In this sense, it is emphasized that it is necessary to implement specific policies so that they contemplate regional realities, peculiarities and specificities of Amazonian riverside communities regarding these infections, the subjects involved and the care practices. Objective: To explore the knowledge of riverine families about Sexually Transmitted Infections. Methodology: Exploratory descriptive research with a qualitative approach. It was carried out in the city of Igarapé-Miri-PA, a riverside community on the Meruú River and is located in the mesoregion of northeast Pará and in the microregion of Cametá and is 78 km away from the capital of Pará, Belém, in the lower Tocantins. Data collection took place in January 2022, through forms. Data were processed in the IRAMUTEQ software and submitted to content analysis. Result: 38 families were interviewed, most of the participants were female, aged between 36 and 59 years old, in a stable union and with different schooling, with emphasis on elementary school. The data pointed to 04 classes, later presented in three categories such as: care practice, knowledge of sexually transmitted infections and accessibility to health services and the availability of treatment. Final considerations: Residents have deficient knowledge about sexually transmitted diseases, whether for prevention or treatment. The care practices mentioned are related to the use of natural resources and presented in the form of bottles and teas, used as an alternative to the scarcity of local primary care services. The lack of accessibility to health services and the conditions of social vulnerability interfere with knowledge, care and continuity of treatment by the public health service.
Acesso aberto (Open Access)
Continuidade do cuidado por enfermeiros a pacientes covid-19 após alta hospitalar na Amazônia paraense
(Universidade Federal do Pará, 2023-11-09) SOUZA, Larissa Aline Costa Coelho de; COSTA, Maria Fernanda Baeta Neves Alonso da; http://lattes.cnpq.br/1219951595746213; https://orcid.org/0000-0002-2763-8050; PARENTE, Andressa Tavares; http://lattes.cnpq.br/2584253687792237; https://orcid.org/0000-0001-9364-4574
Objective: to understand nurses' strategies for continuing care for patients recovered from Covid-19, post-discharge, in a reference university hospital in the Amazon of Pará. Method: qualitative descriptive study, part of a multicenter project, which investigated the reality of ten institutions in Brazilian territory. Interviews were carried out with nurses who worked in clinical sectors caring for patients with Covid-19 at the João de Barros Barreto University Hospital (HUJBB), in Belém (PA), from December 2021 to May 2022. The interviews were transcribed and submitted to content analysis by Bardin, with the support of the free software IRAMUTEQ. Results: 15 nurses were interviewed (12 women and three men), with an average experience of one year and nine months in the Covid-19 patient sector. Three analyzes were carried out with IRAMUTEQ: similarity; word cloud; and descending hierarchical classification (CHD). The words that appeared most strongly were: patient and care. From the CHD, two categories emerged that guided the discussion: the first category dealt with admission and care during hospitalization of patients with Covid-19 in the hospital environment, in which the following stood out: rapid or laboratory testing for positive Covid-19; oxygen therapy; control of vital signs; dressings; among other aspects; the second, addresses hospital discharge and the continuity of care for patients recovered from Covid-19, demonstrating that the discharge process is a medical decision, and, after this process, Nursing assumes care and guidance at home, directing patients subject preferably to the institution's outpatient clinic. Conclusion: it was possible to understand that the nurse identifies the need for transition of care and the clinical conditions that require post-discharge care, but there is still no structured transition care practice in the institution.
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Covid-19 em parturiente e seus neonatos: estudo de caso controle em uma maternidade de referência na Amazônia brasileira
(Universidade Federal do Pará, 2022-10-25) BARROS, Sirley Costa de; PARENTE, Andressa Tavares; http://lattes.cnpq.br/2584253687792237; https://orcid.org/0000-0001-9364-4574; ARAÚJO, Eliete da Cunha; http://lattes.cnpq.br/5906453187927460
The Covid-19 pandemic and its rapid global spread had major health repercussions due to its high potential for transmissibility. Pregnant women at any gestational age and women in the puerperal period belong to the risk group. Objective: To know the clinical evolution of Covid-19 in the parturient and her neonates. Methodology: An observational, retrospective, case-control epidemiological study was carried out, comparing 48 parturients with Covid-19 and their respective neonates (case group) and 98 healthy parturients and their respective neonates (control), hospitalized at Santa Casa de Misericórdia do For. The medical records of parturients diagnosed with Covid-19, during the study period, and parturients without Covid-19, both of any age, of all types of delivery, with or without alterations to the physical examination, admitted to the hospital in April were included. from 2020 to June 2021, in a total of 292 participants (parturients and neonates). Data were collected from medical records, from August 2021 to May 2022, and analyzed using the Bioestat 5.3 program. P<0.05 was considered statistically significant. Results: the mean age among parturients in the case group (n=48) and in the control group (n=98) was 27.7 and 28.5 years, respectively. Analytical statistics and Odds Ration (OR) calculations were statistically significant and higher in pregnant women with Covid-19 for the following variables, respectively: cesarean delivery (p < 0.0001/OR= 6.1), preterm labor (p < 0.0001/ OR=20.2), length of stay longer than 48 hours (p<0.0001/OR=3.6), altered body temperature (p=0.0038/OR=7.5) and altered respiratory rate (p<0.0001/OR=9.6) were statistically significant and greater parturients with Covid19 compared to parturients in the control group. The statistically significant repercussions on newborns of mothers with Covid-19 were: lower percentage of breastfeeding (p < 0.0001/OR= 33.7), length of stay longer than 48 hours (p < 0.0015/ OR= 3.9) and referral the neonatal unit (p < 0.0015/OR= 24.3). The death outcome (fetal+neonatal) had 5 (10.4%) occurrences in the case group. Conclusion: the clinical evolution and outcomes are different between parturients positive for Covid-19 and healthy parturients, with important repercussions on newborns.
Acesso aberto (Open Access)
Desafios do Programa HIPERDIA e implicações para a enfermagem
(Universidade Federal do Pará, 2014-06-27) FERNANDEZ, Darla Lusia Ropelato; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793; GONÇALVES, Lucia Hisako Takase; http://lattes.cnpq.br/6191152585879205; https://orcid.org/0000-0001-5172-7814
INTRODUCTION: The HIPERDIA Program was established in 2001 in primary care because of the severity of epidemiological Hypertension (HBP) and Diabetes Mellitus (DM), conditions that can lead to serious complications instilling limitations and suffering in the lives of their patients and their families. In this context, it is worth mentioning the importance of primary prevention of these diseases and their complications. Past more than a decade of implementation, it is worth to reflect on the impact on health conditions that the program has generated among its users. OBJECTIVES: To elucidate the principles, philosophy and the guiding policy of HIPERDIA Program of the Ministry of Health (MH); describe how the patient care works, by a health team of HIPERDIA Program; explore the life and health behaviors demonstrated by users of HIPERDIA after its insertion into the program. METHODOLOGY DESCRIPTION: This is a Case Study second Yin (2010) whose object of study was a HIPERDIA Program executed in a Basic Health Unit outskirts of Belém. Data were obtained through interviews with users, staff and managers of the program, in addition to direct field observation, consultation records and official documentation of MS. The data analysis was performed by the analytical strategy "Relying on Theoretical Propositions" and the analytical technique "Standard Combination". RESULTS: The deterioration of the HIPERDIA program management illustrated by deficiencies in infrastructure, supplies, medicines and weaknesses in the reference and counter reference network, excessive spontaneous demand that overloads the health team allocated insufficient in number and the context of poverty and urban violence in users living contribute to poor adherence to treatment regimen and limit the team in its interdisciplinary and integral action. Furthermore, the current model of care is grounded in traditional, based on consultations and prescriptions and that has not proved sufficient to fully meet the needs of care to people with chronic condition requiring long-term care by adopting lifestyles more consistent and healthy. FINAL THOUGHTS: Big challenges are drawn against the data emerged from this study and it involves governmental and intersectoral actions that promote improvements in the living conditions of the population which requires political will to investing the necessary resources. Notwithstanding this, the nurse can make a contribution by promoting cultural care and self-care actions, customizing the plan of action and bringing the responsibility of the user and their families in improving their health condition.
Acesso aberto (Open Access)
Desenvolvimento e validação de conteúdo de aplicativo móvel para o controle do HIV/AIDS
(Universidade Federal do Pará, 2022-07-19) GAIA, Melyane de Assunção; SILVA, Richardson Augusto Rosendo da; http://lattes.cnpq.br/2184669241700299; https://orcid.org/0000-0001-6290-9365; RAMOS, Aline Maria Pereira Cruz; http://lattes.cnpq.br/5659071119788962; https://orcid.org/0000-0001-8812-2923
HIV/AIDS is a global health prblem and the northern region of Brazil has stood out with the increase in new cases and high morbidity and mortality throughout the country. Since the decentralization of HIV diagnosis to primary health care (PHC), has gained autonomy in its workflow, which requires a significant technological arsenal for the planning, organization, and operationalization of services. Although an Information and Communication (ICT) usability application is a powerful tool for engagement and health promotion, there is still no application aimed at the mobile nurse's HIV/AIDS workflow. This, the present study as a research question “What is the validity of the content of the content for an application that can mediate the assistance of nurses to people living with HIV?”. OBJECTIVE: To develop the content of a valid mobile media application for health promotion, prevention of HIV infection. METHOD: this is a methodological study for the elaboration and validation of content for a mobile application
Acesso aberto (Open Access)
Discurso dos(as) enfermeiros(as) da atenção básica sobre saúde sexual e reprodutiva das mulheres lésbicas
(Universidade Federal do Pará, 2019) FARIAS, Gesiany Miranda; LIMA, Maria Lúcia Chaves; http://lattes.cnpq.br/2883065146680171; https://orcid.org/0000-0003-3062-2399; LIMA, Vera Lúcia de Azevedo; http://lattes.cnpq.br/5247917929280755; https://orcid.org/0000-0003-0094-4530
Among the priority areas of Primary Health Care (PHC) is the attention on sexual and reproductive health, which must be offered to the population with ethics and humanization, being human rights that are part of public health policies. Refering for women, it reports that they can exercise their sexuality without repression and violence. However, countless people have their rights violated because of their sexual orientation. It cites here, the lesbians who often have their sexual and reproductive rights infringed within health services. Among the professionals who work in these services, the nurse is mentioned, who has an important role in the care and, therefore, should seek the improvement of their practices to provide a better assistance to the lesbians, within their demands and specificity. Thus, this research had the objective of characterizing the discourses of nurses who work in Primary Health Care (PHC) of Belém about sexual and reproductive health of the lesbians. The methodology used was exploratory with a qualitative approach, collected in the city of Belém in a UBS of each one of the 07 administrative districts of that capital. Participants were nurses that atued in these health sectors and that prested assistance to Ministry of Health programs that involved women's health. It were consulted a total of 23 nurses were consulted for the research. However, 10 discorded about the inclusion criteria, resulting in 13 nurses interviewed. The research happenned through a sociodemographic questionnaire, followed by a semistructured interview script. The content analysis was according to the structure proposed by Bardin, perpassing for the steps of preanalysis, material exploration, treatment of results, inference and interpretation. The results and discussions of this research were divided into four categories, the first about stereotypes involving lesbianity, the second reporting the need for training and qualification of these professionals, the third mentioning sexual health in primary care, and the fourth citing the reproductive rights of lesbians. Through this research it can characterize the discourse of these professionals, being fundamental to propose strategies for the reduction or eradication of some fragilities found such as heteronormativity in health care, lack of capacity, the stereotype that affect lesbians and the assistence question in sexual health and reproductive. All these themes were analyzed with theoretical bases, through discussions involving authors that discuss lesbianity, lesbian health, as well as publications of the Ministry of Health through its guidelines and concepts.
Acesso aberto (Open Access)
EDUCAHIV: avaliação da usabilidade de aplicativo móvel para a prevenção e controle do HIV/AIDS
(Universidade Federal do Pará, 2023-11-09) BARROS, Kely da Silva; RAMOS, Aline Maria Pereira Cruz; https://lattes.cnpq.br/5659071119788962; https://orcid.org/0000-0001-8812-2923
Introduction: Aiming to achieve the 95-95-95 target recommended by the United Nations to end AIDS by 2030, the use of mobile health applications, also called mHealth (mobile health), has become a very useful technological equipment in the combating the HIV virus epidemic, as it is a universal and easily accessible tool. It was found that applications based on Ministry of Health Protocols are available in a fragmented manner and that there is no one that brings together all the necessary information and is aimed at nurses, making their daily clinical practice, which tends to meet diverse demands, difficult. Objective: To evaluate the usability of the “EducaHIV. Methodological Course: This is a methodological research, with usability evaluation carried out with nurses who work in Primary Health Care in the Administrative District of Guamá, municipality of Belém. The instrument used to evaluate the usability of the application was the SURE questionnaire ( Smartphone Usability questionnaiRE) which uses a 4-point Likert-type response scale and which also has its own result scale to evaluate usability, in addition, the Content Validity Index-CVI, the CVI of individual items, was calculated and the S-CVI/AVE which is the average of the I-CVI. Results: 17 nurses participated in the research who used the application for an average of 20 minutes using smartphones or tablets and, after using it, answered the printed SURE questionnaire with an average duration of 10 minutes. Data collection took place in a unique approach in October 2023. Data analysis showed that 94% of nurses obtained a usability level of 80 on the SURE scale, ensuring that the application was useful and also obtained a CVI of 0.92 and the S-CVI/AVE of 0.91. Regarding the considerations reported in the questionnaire, the most frequent was the need for the application to zoom to improve the visualization of the content and the insertion of information about drug interactions of antiretrovirals and other medications. Conclusion: Given the satisfactory results, it is concluded that the EducaHIV application has a high level of usability and a good agreement rate, which reflects on the quality of the application and user satisfaction.
Acesso aberto (Open Access)
Elaboração e validação semântica de tecnologia educacional sobre sífilis para mulheres ribeirinhas da Amazônia
(Universidade Federal do Pará, 2022-07-11) FERNANDES, Ticianne Alcântara de Oliveira; ABEN-ATHAR, Cintia Yolette Urbano Pauxis; http://lattes.cnpq.br/8844398079793605; https://orcid.org/0000-0002-6951-3547
The riverside population tends to have a high prevalence of sexually transmitted infections, related to behavioral and social vulnerabilities, especially low education, which makes it difficult to promote sexual health. In this sense, educational health technologies, when validated, are allies in the process of disseminating quality and safe information. Objective: This study aimed to elaborate and validate the semantics of a booklet on syphilis based on the knowledge of riverside women. Study methods: This is a methodological research carried out in three stages, namely: development of educational technology in health; application of the pilot test on the island of Maracujazinho, in the municipality of Acará and validation of the semantics by the target audience on the island of Combu, in Belém do Pará. Result: The elaboration stage was carried out based on the situational diagnosis, for the selection of the generating theme, and by an integrative literature review, which identified the booklet-type printed health educational technology as adequate to address the theme. In the pilot test, carried out with 22 riverside women, the technology was evaluated, where a semantic validity index equal to 1 was obtained, that is, with 100% agreement of the answers in all blocks of questions of the evaluation questionnaire. In the third stage, the semantic validation was carried out with 23 women from the island of Combu, where a semantic validity index of 1 was obtained, that is, 100% agreement using the same evaluation questionnaire as the pilot test. Conclusion:The educational technology needed adjustment only in the quality of the printing paper, its other requirements were considered appropriate and satisfactory. The booklet can be considered valid semantically to address the issue of syphilis with riverside women. In the future, the booklet will receive validation of the reliability and stability of the content by expert judges in the area of health and other higher education.
Acesso aberto (Open Access)
Enfermagem de família: o enfrentamento de famílias cuidadoras de idoso com doença de Alzheimer
(Universidade Federal do Pará, 2017-12-19) CANTO, Maria Gorete Bentes; GONÇALVES, Lucia Hisako Takase; http://lattes.cnpq.br/6191152585879205; https://orcid.org/0000-0001-5172-7814
Alzheimer's is a neurodegenerative disease that causes the decline of cognitive functions, reducing physical and social abilities, interfering in behavior and personality. With the evolution of the picture, Alzheimer's causes a great impact on the daily life of the person becoming more and more dependent on the help of family members. This study had as objective To know the ways of functioning of caregiver families who experience the coexistence of the care of the elderly person affected by Alzheimer's disease, in the domestic sphere. METHODOLOGICAL DESCRIPTION: A descriptive study with a qualitative approach, used as a theoretical and methodological reference point, the Calgary Family Assessment Model. It was developed in the city of Belém-PA, in a reference hospital in geriatrics. The study included 08 families of elderly people diagnosed with Alzheimer's who were being treated at the outpatient clinic of the João de Barros Barreto University Hospital. The semistructured interview technique was used, whose sessions were written in full and drawn (genogram), avoiding the loss or misrepresentation of the information. The analysis of thematic content was carried out in the light of the Calgary Family Assessment Model in three categories: structural, developmental and functional evaluation, presented through the Genogram and Ecomapa through the statements of each family interviewed. RESULTS: From the experiences of caring for the elderly with Alzheimer's, we found that families experienced significant changes and problems of various magnitudes that compromised some relationships in the internal and external structure of families. The Calgary Family Assessment Model allowed us to observe a scientific and systematic structure, through its family assessment categories, because it helped us gather information, which subsidized us in the construction of the Genogram and Ecomapa in a way that allowed us a more structure of the family structure. Conclusion: We concluded that the objective of the research was achieved, since the elderly and their family members require a qualified and systematized assistance in order to enable paths that favor feelings of hope, safety before treatment and, consequently, aiming a satisfactory prognosis. we emphasize the need for new studies related to the family of the elderly with Alzheimer, especially the applicability of the Calgary Family Intervention Model (MCIF), in order to deepen and enable new dimensions, providing to family nursing new collaborations of great scientific relevance.
Acesso aberto (Open Access)
Enfermagem de família: uso do modelo Calgary para avaliação de famílias ribeirinhas
(Universidade Federal do Pará, 2017-12-19) IMBIRIBA, Jéssica Mayara Marques Barboza; CARVALHO, Jacira Nunes; http://lattes.cnpq.br/9434086419077532; https://orcid.org/0000-0002-5464-2434
The family constitutes an important social group, in which the health-disease process occurs and is most often solved, in this way the family acts as a unit of primary care in the health and care of its members. It should be relevant to the study on the health of the Amazon family especially the riverside, as can be observed that the familiar system of these populations present complexities unique evolutionary and contextual features, developed over the years in their interaction with the environment and regional characteristics of the Amazon, besides the professional nurses not being able to carry out evaluations of families, in the perspective that the health models today propose equity, universality, resolubility with co-responsibilities. This dissertation aimed to describe how the families living on the Island of Combu face the problems of life and health in the family everyday. This is a descriptive and explanatory research of a qualitative nature. Where families were evaluated according to the Calgary Model of Family Evaluation (FHH), using observation, the Figueiredo interview form (2012) based on Wright, Leahey (2012) and adapted, field diary, the Genogram and the Ecomapa. As a context of the study we have the Combu Island, and as a target population 10 families attended in the Family Health Strategy that have an area of easy access for the research team. This research complied with Resolution Nº. 466 of 12 of December, 2012 of the National Health Council (CNS). As results the predominant type of family is the single parent led by the woman, the occupation of the mothers was of the home, the occupation of the parents was extractive and the occupation of the student children. The type of contact with the family occurs through personal, and they use the extended family mainly for social company. It has as form of sustenance as being the work of own account, those who have children in school stage reports that all attend the school. They use the ESF mainly for disease prevention and hospital services only when referenced. They have a very present religiosity. The way of access is by means of boats, and the houses do not have refrigeration or heating, the discharge of garbage is given by means of the burning. Regarding family planning, most did not plan their children despite knowing about contraceptive methods, social rights in pregnancy, and social rights of motherhood and fatherhood. We have the most active member as being the figure of the mother, the relatives have shown to have a very strong relationship with each other, and the approximation in relation to the resolutions of problems and affective occurs mainly in the contact mother and first-born. In conclusion, it was possible to observe that the nursing professional only has to carry out actions of health education with the purpose of guiding the families and reducing the impacts of the absence of the public power in relation to the issues of basic sanitation and water supply.
Acesso aberto (Open Access)
Estudo dos óbitos maternos na região metropolitana de Belém
(Universidade Federal do Pará, 2017-02-07) CAMACHO, Elyade Nelly Pires Rocha; ARAÚJO, Eliete da Cunha; http://lattes.cnpq.br/5906453187927460; https://orcid.org/0000-0002-1312-4753
Data on maternal mortality, whether in developed or developing countries, are more disparate than any other indicator of public health in Brazil. During the United Nations Millennium Development Pact, eight Development Goals were adopted, among them, to reduce maternal mortality by 75% by 2015. The aim of the study was to conduct a study on the occurrence of maternal deaths in the region Metropolitan area of Belém that were notified through the Mortality Information System (MIS) from January 2013 to December 2015, in addition to describing the main causes of maternal mortality. The study is an epidemiological, descriptive, quantitative, analytical, retrospective and documentary approach. It is performed with secondary data stored at the Maternal Mortality Committee consisting of results reported as maternal deaths. From January 2013 to December 2015, 53 deaths were reported in 2013, 45 maternal deaths in 2014 and 40 deaths in 2015. The data identified a maternal mortality ratio (MMR) of 160.3 deaths per 100 A thousand live births in 2013, 136.0 deaths per 100,000 live births in 2014 and 121.9 deaths per 100,000 live births in 2015. We can say that the epidemiological profile is not well defined, diverging with several Literatures. The main causes of maternal mortality are in the world, in Brazil and especially in the metropolitan region I of the state of Pará, the four apocalyptic horsemen, who kill women, Hypertensive Syndrome, Hemorrhage, Sepsis and Abortion remain. That is, despite all the discussions on the subject, the RMM does not diminish over the years, reinforcing the need for improvements in the state's public health.
Acesso aberto (Open Access)
Experiências de familiares cuidadores de pacientes oncológicos em cuidados paliativos à luz da teoria de Meleis
(Universidade Federal do Pará, 2022-08-09) GOMES, Ana Carolina de Sousa; SANTANA, Mary Elizabeth de; http://lattes.cnpq.br/6616236152960399; https://orcid.org/0000-0002-3629-8932
Cancer is considered the second leading cause of death in the Region of the Americas, being diagnosed in the year 2020, four million new cases and about 1.4 million deaths due to the disease. At a global level, one in six deaths are related to cancer, highlighting the need for investments in health promotion and in the search for changing the patterns of exposure to risk factors. The diagnosis of the disease mobilizes in patients and their families positive and negative feelings that need to be understood by health professionals. Therefore, families are included in the care process, as a way of adapting them to situations related to illness and terminality, so that they can also provide adequate support to their patients. At this moment, family members experience a transition to a new role, as a family caregiver. In view of such considerations, and the relevance of this theme in the field of Nursing, Afaf Ibrahim Meleis' Theory of Transitions was selected as the theoretical basis for the present study. The general objective is to analyze the experiences of family caregivers of cancer patients in palliative care, in the light of Afaf Meleis' theory of transitions. And as specific objectives: to understand the transition experiences of the family member of patients in oncological palliative care when exercising the role of caregiver; to describe the facilitating and inhibiting factors of transition in the process of caring for cancer patients; to know how family caregivers experience grief and its phases during the process of caring for a patient in oncological palliative care. This is a descriptive study with a qualitative approach. Held at the Palliative Care Clinic (CCPO) 1 and 2 of the Ophir Loyola Hospital (HOL), in the period of June 2022. Participated in the study 15 family caregivers of cancer patients undergoing treatment at these held, aged over 18 years, with ties of kinship, affection and/or friendship with the patient, in physical, emotional, and psychological conditions to answer the questions in the interview script, and who voluntarily agreed to participate in the study after reading and signing the Free and Informed Consent Term. Data analysis was carried out using Braun and Clarke's Thematic Analysis (TA), a qualitative analysis technique composed of six phases. Thus, three major themes emerged, which were analyzed and discussed based on the model of Meleis' Transitions Theory: the transition of roles, the facilitating and inhibiting factors of the transition to the care process and the stages of mourning and religiosity in the death process and die. Such categories show a situational transition given the acquisition of a new role, identifying the properties of awareness, engagement and change, with the acquisition of skills and attitudes towards the illness of a loved one, permeated by nursing therapies and the multidisciplinary team in the context of the palliative care, the results reflect that not all family caregivers experienced a healthy transition. From the results, it was possible to understand the experiences of family caregivers of cancer patients in palliative care, and the importance of nursing interventions in the process of death and dying, thus promoting a healthy transition in the context of care.