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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Representações sociais da tuberculose por pessoas com tuberculose e suas implicações para o seguimento do tratamento
(Universidade Federal do Pará, 2021-06-28) MOURA, Adriana Alaide Alves; HUARCAYA, Sofia Sabina Lavado; http://lattes.cnpq.br/7107598022816897; SILVA, Sílvio Éder Dias da; http://lattes.cnpq.br/0084512862619143; https://orcid.org/0000-0003-3848-0348
Introduction: Tuberculosis remains recognized worldwide as an important problem that involves public health policies, requiring the development of actions aimed at its control, considering humanitarian, economic and public health aspects. For every case of tuberculosis, the directly observed treatment must be carried out, as it is not possible to predict the cases that will adhere to the treatment, and it is necessary to build a bond between the patient and the health professional. This is because another important aspect that permeates the pathophysiological understanding of the disease is related to the psychological and social issues that tuberculosis presents, as it is associated with stigmas and representations anchored in interpersonal relationships. It is in this context that the Theory of Social Representations is applied, as it is understood that understanding the representations built about tuberculosis and its implications for the follow-up of treatment is fundamental for promoting health and combating this disease. Objective: To understand the social representations of people with tuberculosis about the disease and its implications for treatment follow-up. Method: This is a descriptive study, with a qualitative approach, using the Theory of Social Representations as a theoretical basis. The study setting was the municipal health unit of Guamá, District DAGUA, in the city of Belém. People with a positive diagnosis of tuberculosis and undergoing treatment directly observed in the study unit for a period of one month or more participated in the research. quantitative was defined by applying the data saturation technique. Data collection was performed using two techniques: free word association and semi-structured interview. For data analysis, thematic content analysis was used. Results: from the analysis of the data obtained, the registration units converged into three categories, namely: Representations of tuberculosis and its impacts on the diagnosis; the faces of treatment: challenges in terms of follow-up and hope; and Constructions of living with the disease in the family and society. The ways of living with the disease in the daily work, family and social relationships were marked by concerns and practices related to direct contacts or through objects. Suffering is strongly linked to the treatment routine, which implies a radical change in lifestyle, but also figures as a hope for a cure. The family emerges as a welcoming place; however, there is still strong social discrimination and prejudice marking the social representations of tuberculosis. Final Considerations: The impact of the diagnosis, representation and living with the disease can transform daily life, work, family relationships and society. Discrimination and prejudice have an impact on social life, and denote the need to disseminate qualitative information with a view to reconfiguring such representations so that the patient can be better welcomed and included. Nursing as an active team in this care process must remain present and sensitive to the understanding of these various aspects, contexts and representations that surround them, being also active in public health policies, educational actions and scientific research that contribute to quality of assistance and in the reduction of prejudice.
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Serviços e programas educacionais de prevenção e controle da tuberculose em ambiente prisional: revisão integrativa
(Universidade Federal do Pará, 2021-08-30) SILVA, Andresa Pereira; GONÇALVES, Lucia Hisako Takase; http://lattes.cnpq.br/6191152585879205; https://orcid.org/0000-0001-5172-7814
Tuberculosis (TB) is one of the main causes of morbidity and mortality related to infectious diseases in developing countries. The incidence rate of TB in the prison population in Brazil is about 28 times higher than that of the general population, which is 34.8/100,000 inhabitants. TB remains a serious public health problem worldwide. WHO and nations are making efforts to end TB as a public health problem by 2035. Investing in health education is one of the WHO's bets and one of the greatest challenges for prison services. Objective: To identify and synthesize the scientific evidence present in national and international literature about educational services and programs related to the prevention and control of tuberculosis for Persons Deprived of Liberty (PPLs) in prisons. Method: Integrative Literature Review (RIL) based on the PICO strategy to formulate the research question: P (population) = PPL; I (interest) = intervention of educational services and programs for TB control and prevention; C (comparison – not included here); and O (outcome) = evidence of TB prevention and control in educational services and programs for PPL. Literature was collected in selected databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), SciVerse SCOPUS and Cochrane Library. Of the total of 10,903 identified articles, those duplicates were excluded and after reading the titles and abstracts with application of the inclusion and exclusion criteria, 103 articles were pre-selected. Then, a careful reading and analysis of the pre-selected articles was performed, resulting in the selection of 12 to compose the sample of this review. These 12 articles received the following classification: nine of them made up Category I – Control and prevention of tuberculosis in prisons; and the other three articles, Category II – Practice and educational program for tuberculosis control in People Deprived of Liberty. Conclusion: The authors of the studies included in this review propose the Intersectoral Cooperation of Public Health and the Prison Service through joint actions to control TB and prevent the spread of the disease in the community. They emphasize that joint action is only possible if there is political will from the authorities responsible for the geopolitical region where the prisons are located.
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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.
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Infecções sexualmente transmissíveis: o imaginário de remanescentes de quilombos
(Universidade Federal do Pará, 2021-06-29) SOUZA, Isis Tarcila Vital de; CARVALHO, Jacira Nunes; http://lattes.cnpq.br/9434086419077532; CASTRO, Nádile Juliane Costa de; http://lattes.cnpq.br/2532971599666350; https://orcid.org/0000-0002-7675-5106
Currently, quilombola communities in Brazil are multiple and are distributed throughout the national territory, in the North there are 873 quilombola communities an important milestone in history, is that, the first community to receive the title is located in the State of Pará. Historically the communities they suffer from a lack of infrastructure, precarious access to health, education, and basic sanitation, revealing that this group lives in a situation of vulnerability, the result of a historical process of slavery. In this respect, the vulnerability of these populations is recognized, considering the preventive and assistance difficulties with regard to Sexually Transmitted Infections. These infections are caused by different types of microorganisms with very specific clinical evolution and expressions. Being transmitted, above all, by direct or indirect sexual contact and occasionally by blood. The aim of this study was to know the imagery / perception of quilombos remnants regarding sexually transmitted infections. This is a qualitative study with information obtained from semi-structured interviews and the data analyzed using the Collective Subject Discourse technique. From the result it became possible to group the discourses of the residents of the community that remains from quilombos of ItacoãMirim about sexually transmitted infections in four categories: 1) Discourse on the perception of what is Sexually Transmitted Infection. 2) Speech about transmission. 3) Discourse on prevention. 4) Discourse on treatment. It is believed that the present study made an important contribution to nursing, since it brought evidence that subsidizes care aimed at the remaining quilombo community and its imagery regarding the Ists exhibiting their risky behaviors and attitudes.
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Os determinantes sociais, a infecção pelo HIV e a AIDS em uma capital na Amazônia brasileira: análise espacial e temporal
(Universidade Federal do Pará, 2021-05-21) DIAS, Bruna Rafaela Leite; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793
Almost 40 years after its discovery, the Human Immunodeficiency Virus (HIV) continues to be a challenge for public health worldwide. In Brazil, the states of the Northern region have the greatest impact of the HIV epidemic, with a continuous increase in detection rates. This study aimed to perform the spatial and temporal analysis of the incidence of HIV infection and AIDS, and its relationship with social determinants. Ecological study employing secondary data of cases reported to the Notifiable Diseases Information System (SINAN), in the period 2007- 2018, of individuals living in the city of Belém/PA. Temporal analysis was performed using Box and Jenkins methodology. For the spatial analysis, incidence was analyzed using autocorrelation and spatial regression techniques, Kernel density to study the expansion of the HIV epidemic in the city, and sweep statistics to identify clusters of risk. During the study period, 6,007 new cases of HIV/AIDS were reported to SINAN. Time series analysis revealed stability of incidence from 2007 until October 2016, followed by an upward trend. Starting in January 2017, incidence rates showed irregular fluctuations until the end of December 2018. Seasonal behavior was observed for the forecast from 2019 to 2022. High incidence clusters were located in the central and transitional areas of Bethlehem. The epidemic progressed from 2007-2010 to 2015-2018. The spatial high-risk zone for HIV was observed in the transition zone (RR = 3.65; 95% CI = 2.47 - 5.34; p = 0.00016), while the spatiotemporal high-risk zone was observed in the central, transition and expansion zones (RR = 4.24; 95% CI = 3.92 - 4.52; p = 0.000). Incidence rates were directly correlated to Family Health Strategy (FHS) coverage (adjusted R² = 0.38). The upward trend observed in the incidence rates of HIV infection and AIDS in Belém may be correlated with the efforts of public policies to combat the virus. However, the irregular behavior in incidence rates from 2017 and the seasonal behavior revealed in the forecasts suggest a loosening in public health policies. This study provides subsidies for the development of public health strategies to combat HIV.
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Projeto (s) indutor (es) da integração ensino e serviço: impacto no processo de formação e no cotidiano do trabalho
(Universidade Federal do Pará, 2021-06-16) ROSA, João Victor Moura; LOPES, Márcia Maria Bragança; http://lattes.cnpq.br/6740484061412959
The teaching-learning process established from the integration between teaching and service through the insertion of students in the health service can lead to new ways of work organization in health, favoring a better qualification for the service. In this context, the Training Program in Child Health Care - Multicampi Health Internship in the Federal University of Pará - UFPA is inserted, which seeks the qualification of management processes in training for care, teaching-service-community integration, in an articulated manner between the Sistema Único de Saúde – SUS and the educational institution, whose objective was to identify the impacts observed in the daily work and in the training of nursing students who participate in projects that promote the integration of teaching and service. It was used as theoretical support Yin, Strauss; Corbin. The guidance for analyzing the collected material was given through interpretive readings on Integration Teaching and Service Yin (2015). The analysis of interviews was based on Strauss and Corbin, (2008) where they were based on Teoria Fundamentada nos Dados (TFD). The results showed the contribution of the inductor project object of this research to the education of nursing students, as the experience acquired in the service strengthened their education. Being inserted in Inductor Projects reinforced the practice of Nursing Course at UFPA, which introduces its students early in the field of practice, contributing positively to their training. In general, there is a positive impact on the training process and on the daily work, understanding the inductive role and why not say transformative of the Multicampi health Project, considering its impact on the quality of education and care provided to the user, as well as its power of reflection, on part of professional preceptor, as to the importance of praxis in the quality of life of the assisted population. Regarding the contribution of this research, it is believed that its realization will contribute both to the educational Institution, particularly the Nursing Course at UFPA, as to the Municipal Health Department of Belém, since it brings in its result, indicators that demonstrate the positive impact effect of Inductor Projects in the quality of care, involving educational institutions, health services and users of the Sistema Único de Saúde, providing an important indicator for the expansion of strategies such as the Multicampi Health Project in other municipalities and regions of the State of Pará.
Acesso aberto (Open Access)
Mortalidade por AIDS em amazônidas e seus determinantes sociais: análise espacial e temporal
(Universidade Federal do Pará, 2021-05-20) RODRIGUES, Taymara Barbosa; GOMES, Dulce; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530
Acesso aberto (Open Access)
Gestão de pessoal de enfermagem por competências em serviços de saúde: revisão de escopo
(Universidade Federal do Pará, 2021-04-06) OLIVEIRA, Sebastião Magno; MENEGAZ, Jouhanna do Carmo; http://lattes.cnpq.br/2423764452219953; https://orcid.org/0000-0002-7655-9826
Introduction: Due to its recognized benefits in the public scenario, the so called competency management model has been introduced in institutions that provide health care services within the scope of the Public Unified Health System (SUS). Institutions providing health services were led to verify the management models used and adapt them to the changes originating from globalization, starting from the need for managerial molds capable of putting into practice the skills of workers, for this reason, the use of tools such as management by competences are being inserted in health services. Objective: Describing, based on the scientific literature, how nursing staff management by competencies in health services occurs. Method: This is a scoping review based on the protocol of the Joanna Briggs Institute (JBI). The researched articles were obtained using two search strategies, based on LILACS, MEDLINE, and SCIELO, using descriptors, keywords, and Boolean operators, without time limits, in Portuguese, English, and Spanish. The data were collected in the month of September 2020, and 165 articles were collected. The studies found were transferred to the Rayyan® application software, with the aim of giving the following steps and the review greater agility and safety. After excluding duplicates 148 articles remained, subsequently reading title and abstract 20 articles were classified as eligible for review, which were read fully and, with the exclusions, five articles were included in the review. The selection of studies was carried out based on the inclusion criteria. Data analysis was performed using descriptive statistics and through Bardin's content analysis. A qualitative analysis of the extracted data related to the competency management process was carried out. Result: As a result, five studies related to the theme of the review were obtained with contributory attributes to compose it. The results were organized by topics of interest to the work according to the JBI protocol. The studies showed a time window of publications on the theme in the national context, which suggests a small number of studies on the theme in Brazil. The results show that most research was conducted in public health institutions and was carried out with nurses. This fact reinforces the relevance of nurses in the process of managing people in health services. One point of weakness found was regarding the concept of competence being evidenced in only one article. In four studies, some type of material, instrument, or reference system was evidenced, but they did not specifically address the theme of management by competencies, but rather dealt with issues related to the process of managing people, quality and other care processes which involve the professionals of the institutions in general, and not specifically the nursing team.
Acesso aberto (Open Access)
Conceitos de gestão e gerência do cuidado de enfermagem: revisão de escopo
(Universidade Federal do Pará, 2021-02-20) BARROS, Aurilívia Carolinne Lima; MENEGAZ, Jouhanna do Carmo; http://lattes.cnpq.br/2423764452219953; https://orcid.org/0000-0002-7655-9826
Introduction: Terms “Care Management” and “Care Administration” are strongly present in the reality of health services and academic literature in studies at the most diverse care levels. The scope and differentiation of the terms Nursing Care Management and Nursing Care Administration are a matter of great concern. Objectives: To define the Management and Nursing Care Administration concepts based on the existing scientific production. Methods: This is a scoping review based on the protocol of the Joanna Briggs Institute. Data was collected in the 04-25/04/2020 period. The researched papers were retrieved from LILACS, CINAHL, MEDLINE, and SCOPUS databases without time limits. The sample consisted of studies published in Portuguese, English, and Spanish from 2007 to 2020. Results: We established a structural framework that involves the Nursing Care Management and Nursing Care Administration concepts. The definition and characterization of each component of this framework, its relationships, and, mainly, the conceptualization of the Care Management and Nursing Care Administration terms. This study identified that working in “Nursing Care Management” requires the same skills as working in “Nursing Care Administration”. However, such concepts are mobilized under different frequency and density, and skills with more significant strategic-administrative nuances are more strongly mobilized in the “Nursing Care Administration” thematic core. In contrast, skills mobilized show essentially strategic-cognitive nuances in the “Nursing Care Management” thematic core.
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Preditores da sífilis gestacional em um estado da Amazônia brasileira: um estudo de caso e controle
(Universidade Federal do Pará, 2021-12-03) UCHÔA, Thais Lopes do Amaral; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950; ARAÚJO, Eliete da Cunha; http://lattes.cnpq.br/5906453187927460
Introduction: Advances in public policies aimed at maternal and child care implemented in Brazil in recent decades have not yet had an impact on reducing gestational syphilis and, especially, congenital syphilis. In Pará, there is still a high number of cases of gestational syphilis detected in childbirth and puerperium. The factors that relate to the maintenance of this context are unknown. Objective: To determine the predictors of gestational syphilis in a state in the Brazilian Amazon region. Methods: Unpaired case-control study, carried out in a public reference maternity hospital in Pará. Data were collected from November 2020 to July 2021, from the application of the form, analysis of the pregnant woman's card and medical records. Women diagnosed with syphilis during pregnancy, childbirth or puerperium were considered as cases. Controls were women without a diagnosis of syphilis in the pregnancy puerperal cycle. The response variable was the diagnosis or not of gestational syphilis, the event being considered the diagnosis of gestational syphilis in the prenatal, delivery or postpartum period. Independent variables were grouped into: a) sociodemographic; b) gynecological and obstetric by two (02) categorical variables and five (05) discrete variables; c) sexual and obstetric practices by eight (08) categorical variables; d) knowledge is composed of fifteen (15) categorical variables and e) Attitudes is composed of six (06) categorical variables. The sample size, calculated using the Kelsey method, was 204 participants, 68 cases and 136 controls. To test the main hypothesis of the study, multiple logistic regression analysis was performed. In the Bioestat 5.3® program, the chi-square test of independence, tendency and G test were applied. In the Minitab 20® program, descriptive analyzes and logistic regression were performed. Odds ratio, 95% confidence interval was calculated. P values <0.05 were considered statistically significant. Results: Among the 68 cases and 137 controls, age ranged from 15 to 41 years, mean age was 26.1 years (SD: 6.2). In the multiple logistic regression, the cases are independently associated with the lowest number of prenatal consultations (OR: 0.82; p = 0.02), history of previous STI (OR: 24.8; p = 0.00 ), spontaneous abortion (OR: 2.86; p = 0.025) and difficulty in talking with the partner about the use of sexual condoms in relationships (OR: 4.43; p = 0.00). Among the factors of knowledge and attitudes, cases were associated with knowledge about vertical transmission (OD: 0.24; p= 0.019), treatment with penicillin (OD: 0.47; p= 0.023) and on the availability of treatment in basic health units (OD: 0.14; p= 0.014). However, they are associated with the lack of knowledge about the lack of vaccine (OD: 1.94; p= 0.04). The analysis of variables related to attitudes showed an association of cases (OD: 2.40; p= 0.016) with inadequate attitude about the beginning of prenatal care. There is an increase in reactive cases from the 1st trimester to the puerperium with p < 0.0001, with the highest significant proportions of reactive cases during delivery and postpartum. Conclusion: gynecological-obstetric factors, sexual and reproductive practices and knowledge are associated with gestational syphilis. In a population with precarious socioeconomic conditions, no association of these factors was demonstrated. Actions for monitoring and evaluating prenatal care are urgent.
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A compreensão dos socorristas acerca do atendimento pré-hospitalar para idosos à luz da política HumanizaSUS
(Universidade Federal do Pará, 2021-12-20) RODRIGUES, Thamyris Abreu Marinho; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793; https://orcid.org/0000-0001-5026-5080; OLIVEIRA, Marília de Fátima Vieira de; http://lattes.cnpq.br/7030765721580568; https://orcid.org/0000-0003-4303-9434
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Prevalência de Chlamydia trachomatis e fatores de vulnerabilidade associados em uma população ribeirinha da Amazônia brasileira
(Universidade Federal do Pará, 2021-12-20) GALVÃO, José Jorge da Silva; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
Introduction:Chlamydiatrachomatis is widely distributed in urban and non-urban populations, including riverside populations. These populations have low access to laboratory diagnosis in Primary Health Care and there are difficulties in clinical diagnosis, which do not allow the break of the chain of transmission. The riverside dwellers in the Brazilian Amazon live in an area of high incidence of sexually transmitted infections and have low socioeconomic indicators. There are no studies addressing the prevalence of Chlamydiatrachomatis and riverine populations in light of social, individual, and programmatic vulnerability factors. Objective: To identify the prevalence of Chlamydiatrachomatis and associated vulnerability aspects in an adult riverine population in the Brazilian Amazon. Method: Observational, cross-sectional study conducted among adult residents of Ilha do Combú, in the city of Belém. We adopted an expected frequency of 50%, acceptable margin of error of 5%, confidence level of 95%, design effect 1.0, which resulted in a sample of 306 participants, with an additional 8.5% being included considering a percentage of participants who did not answer or did not know. The sample size calculation was performed in the Statcalc - Sample size and power module of the EPI INFO Version 7.2.2.16 program. For data collection two questionnaires were applied, one validated and the other adapted, evaluated by judges and previously tested for the present research, with the intention of identifying the knowledge, attitudes and practices about sexually transmitted infections, besides socio-demographic data. The variables used to test the main hypothesis of the study were categorical: aspects of the individual, social and programmatic dimensions are associated with the chances of Chlamydia trachomatis infection among adult river dwellers. The dependent variable analyzed was reagent serology for CT. The diagnostic criterion for reagent serology was the detection of antibodies of the IgG and IgM classes of CT in an enzyme linked immunosorbent assay (ELISA). The independent variables analyzed corresponded to the vulnerability aspects described from the literature. To identify the prevalence of chlamydia, a peripheral blood sample was collected from the study participants. The sample then underwent analysis for IgG and IgM anti-Chlamydia trachomatis antibody detection by enzyme-linked immunosorbent assay (ELISA). Logistic regression was the method of choice for expressing the odds of finding markers of Chlamydiatrachomatis infection among those exposed to vulnerable conditions relative to the unexposed. Univariate binary regression was selected for multiple regression, adopting the stepwise model. All statistical analyses were done using Minitab 20® and Biostat 5.3® software. Significance level of 5%, 95% confidence interval (CI) and Chance Ratio (RC) were adopted. Results: The study sample consisted of 325 participants. The prevalence of Chlamydia trachomatis infection markers was 22% (72/325%; 95% CI: 17.5%; 26.4%). For the isolated IgM marker, the prevalence was 5.5% (6/109; 95% CI: 1.2%; 9.8%), with 100% of cases being female. Most participants had low educational level and low wage income, 56.6% (184/325) never attended school or had only elementary level; 68% (222/314) lived with monthly wage income less than one minimum wage. In the multiple logistic regression analysis, after adjustments, the participants who had their condom broken and were beneficiaries of government income transfer programs were almost twice as likely to have the presence of markers of Chlamydiatrachomatis infection when compared to those who did not have their condom broken. Conclusion: In this population, besides the low social conditions, vulnerability factors were found in the individual and social dimensions that increased the chances of infection by the bacteria, such as low education, low family income and poor access to health services. The identification of these aspects enables the choice of the most appropriate combined prevention strategy for these populations.
Acesso aberto (Open Access)
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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A atuação de enfermeiros nos institutos federais de educação da região norte do Brasil: visão pré e pós pandemia de COVID-19
(Universidade Federal do Pará, 2023-06-13) SOUZA, Jamily Silva; CASTRO, Nádile Juliane Costa de; http://lattes.cnpq.br/2532971599666350; https://orcid.org/0000-0002-7675-5106
Introduction: Nursing is present on several campuses of the Federal Institutes of Education (IFE), at the service of the academic community; they work mainly in health promotion and in advising teaching, research and extension activities. Due to the Covid-19 pandemic, several control and prevention measures were adopted, also affecting educational institutions such as IFE that reorganized their academic and administrative activities in the remote system, also affecting nurses who work in these institutions, with essential actions to guarantee of the health and safety of the school community and have their importance highlighted in the context of the pandemic. Objective: To analyze the performance of nurses in IFE in the North of Brazil in a pre and post Covid-19 pandemic view, considering the regional Amazonic specificities. Methodology: descriptive research with a qualitative approach carried out with nurses who work in community care at the 7 IFE in the 7 States of the North Region of Brazil. Data collection took place between October 2022 and January 2023 with semi-structured interviews following a script divided into two axes: 1) Characterization of the professional profile of the nurses targeted by the research; and 2) The performance of nurses in the pre- and post-pandemic context within their campuses. Data were processed using the IRAMUTEQ software and submitted to content analysis. Result: 20 nurses from 5 Institutes were interviewed. Most of the participants were female, aged between 28 and 37 years and specialists. Most had between 4 and 7 years of service in the institution. The data organized at Iramuteq pointed five classes, later presented in four categories: The Work place and Training, Work before the Covid-19 Pandemic, Work during the Covid-19 pandemic and Current work perspectives. Final considerations: Nurses in the IFE work mainly in health education, in addition to carrying out nursing procedures and advising on student care; during the pandemic, most of these activities were adapted to the remote model and new ones emerged as support in the institution's planning to combat Covid-19. Some difficulties that already existed were aggravated by the pandemic, such as deficiencies in infrastructure and means of communication, due to factors such as management problems and the peculiarities of the region. Nursing work gained recognition in the pandemic but needs to be further studied and regulated when it comes to performance in educational institutions such as IFE.
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)
Formação de enfermeiras e enfermeiros de instituições públicas da Amazônia brasileira sobre saúde da população negra
(Universidade Federal do Pará, 2023-11-10) FARIAS, Iago Sergio de Castro; CASTRO, Nádile Juliane Costa de; http://lattes.cnpq.br/2532971599666350; https://orcid.org/0000-0002-7675-5106
The processes of exclusion of the black population in society stem from Brazil's slaveholding roots, based on theories of population whitening and racial superiority. Through a false racial democracy, these theories obstruct the access of the black population to education and health. This study aims to understand how this exclusion institutionally affects health training about the black population and access to this training. Objective: This research aims to understand the construction of knowledge and nursing training regarding the health of the black population in the Amazon. Method: It is a documentary study based on the analysis of Pedagogical Political Projects of Nursing courses in public universities in the North region. The study was theoretically based on Vygotsky's historical-social theory and Bell Hooks' concepts of transformative education, under thematic analysis according to Bardin. Results: In total, 12 PPPs were analyzed, identifying 10 curricular activities, of which 04 were about black populations and 06 were extension and research projects on the subject. From the findings, four thematic axes emerged: "Training and Health in the Amazon," "Educational Triad and Influence on Complementary Training," "Affirmative Actions and the Paradigm of Higher Education," and "Scientific and Structural Racism in the Educational Process." Final Considerations: There are deficits in health training across the entire university triad, demonstrated by low production, projects, and absence in PPPs. It is necessary to reformulate the PPPs to provide genuinely equitable and comprehensive health training and care.
Acesso aberto (Open Access)
Crianças com transtorno do espectro autista: os desafios do cuidado e tecnologias cuidativas na ótica dos profissionais de saúde
(Universidade Federal do Pará, 2023-11-08) SILVA JÚNIOR, Marco Antônio Mesquita da; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793; https://orcid.org/0000-0001-5026-5080
Autism Spectrum Disorder (ASD) is a behavioral syndrome with developmental, behavioral and social interaction disorders. Care technologies, used by the multidisciplinary team, are strategies that seek to promote satisfactory results in social interaction, behavior and breaking stereotypical routines. The study aims to reveal the challenges that permeate the care of health professionals who care for children with ASD and to learn about the care technologies used in the care of health professionals who care for children with ASD. This is a descriptive study with a qualitative approach, carried out between July and August 2023. 17 health professionals were interviewed. The data were analyzed from the perspective of Bardin's content analysis technique and processed by the software Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires. The results of processing the Iramuteq software identified 6 classes and, through semantic grouping, three thematic categories emerged: “Techniques and strategies used in the intervention and behavioral management of children with ASD”; “Challenges in providing care to children with ASD” and “Role of the family in caring for children with ASD: Challenges, Acceptance and Overcoming”. It is concluded that it is essential to adopt multidisciplinary approaches, which integrate techniques, technologies, specialized clinical care, family support and integration into the social context, to promote comprehensive care for children with ASD.
Acesso aberto (Open Access)
Práticas de enfermagem no processo de trabalho na atenção primaria à saúde: desafios no contexto da pandemia da COVID-19 na região norte do Brasil
(Universidade Federal do Pará, 2023-11-01) REIS, João Paulo Monteiro dos; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950
Objective: To understand the challenges related to the work process and nursing practices in PHC faced by nurses during the covid-19 pandemic in the Amazon region. Methods: Observational study, with a qualitative cross-sectional design carried out in four states in the northern region: Pará, Acre, Rondônia and Roraima, located in the Brazilian Amazon. The collection instrument was a semi-structured interview where the participants were nurses who worked in care or management in primary health care units. The interview data were processed using Bardin's content analysis and the IRaMuTeQ software version 0.7 alpha 2. Results: The average age of the research participants was 40.8 years, the majority were women, 66.7% were mixed race , 30% white, 3.3% black and one nurse did not declare their color. Based on the analysis carried out by the software, the corpus was fragmented into 651 text segments, representing 84.94% of the interview content, resulting in three thematic categories and one subcategory: category 1- The impact of covid- 19 in the assistance of professional nurses; Subcategory 1: nursing care for priority groups during covid-19 category; 2- Nurse care in PHC during covid-19; Category 3- the challenges and biopsychosocial aspects of professional nurses in facing Covid-19. Conclusion: Nurses faced several challenges during the covid-19 pandemic period, such as a substantial increase in demand for healthcare, placing an intense workload on nurses who worked during this period in the Amazon region. There was a need to quickly adapt to new care protocols, including screening, testing and monitoring of patients with Covid-19. A significant transformation was triggered in the way nurses carried out their work, with the internet playing a crucial role in this new work process. There was a significant impact on the biopsychosocial health of nurses.
Acesso aberto (Open Access)
Práticas individuais e coletivas dos enfermeiros na atenção primária à saúde: um panorama da região norte do Brasil
(Universidade Federal do Pará, 2023-10-31) VELOSO, Caroline de Morais Zanchin; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950
INTRODUCTION: territorial characteristics, with an emphasis on the geography of the North region, require individual and collective practices in the work of Primary Health Care nurses that meet the peculiarities of the populations that inhabit this territory. OBJECTIVE: to analyze individual and collective practices that are associated with the dificulties of nurses working in Primary Health Care in the North region. METHOD: mixed methods study carried out with Primary Health Care nurses in the North region, between November 2019 and August 2021, using an electronic form and interview. The data were analyzed using the Bioestat program and the IRaMuTeQ® software, using Bardin's thematic content analysis. RESULTS: 626 nurses participated in the quantitative stage and 31 in the qualitative stage. Difficulty in carrying out practices was described by 15.7% (98/626) of nurses. Four categories were identified in the qualitative analysis: professional autonomy in their activities; need for a prescription from another professional to complete a service; work facilities; difficulties at work. Among collective practices, there was an association between difficulty and participation in the management of inputs (p = 0.03), but it was evident from the interviews that the nurse participates in the request for technical material, but does not receive it as requested. In individual practices, there was an association between the difficulty in carrying out a consultation (p = 0.03) and the prescription of medications (p = 0.02). The qualitative analysis demonstrates that the nurse needs a prescription from another professional to complete a service he started. The association between difficulty and resolution showed significance between prenatal consultation (p = 0.000), activities to monitor child growth and development (p= 0.001; 25%) and family planning (p= 0.000; 25.7%) . However, these are practices that nurses report that they exercise with greater autonomy. The association of difficulty with caring for hypertensive patients (p <0.0001) and diabetics (p<0.0001) also showed insufficient resolution. In these activities, the nurse describes needing the doctor to prescribe medications and complete the care. CONCLUSION: The work carried out by primary health care nurses requires the continuous improvement of these professionals' skills and abilities, especially with regard to nursing consultations and medication prescriptions. The implementation of nursing protocols and continuing education help in the development of professional autonomy, aiming at the quality of the service and the resolution of the assistance provided to users.
Acesso aberto (Open Access)
Marketing nos negócios de enfermeiros empreendedores no Brasil: uma análise na rede social Instagram
(Universidade Federal do Pará, 2023-08-31) FONTES, Victoria Malcher Silva; MENEGAZ, Jouhanna do Carmo; http://lattes.cnpq.br/2423764452219953; https://orcid.org/0000-0002-7655-9826
INTRODUCTION: For nurse entrepreneurs, it is essential to understand the dynamic business environment, which includes marketing strategies. Reason of prosperity or decline of enterprises, hold of marketing skills is among the fundamental bases to undertake. In the Covid 19 crisis, the importance of the latest version of marketing, digital, was highlighted. An indispensable tool in this context is the social network Instagram. OBJECTIVE: To analyze how entrepreneurial nurses use marketing in their businesses through the social network Instagram. METHOD: Quantitative documentary study, conducted in a virtual way, to analyze the profiles of 25 entrepreneurial nurses in the social network Instagram. Data collection occurred between 08/02 to 15/02 of 2023. Google Forms was used, with a questionnaire containing 48 topics divided into 3 sections. Data analysis relied on Microsoft Excel software. Descriptive statistics were performed, which involved calculating the mean, maximum and minimum value of the data. Absolute and relative frequencies were also calculated. RESULTS: Mostly, the profiles analyzed are categorized as professional accounts (92%, n=23) in "medicine and health" (24%, n=6). The highest frequency of entry to Instagram occurred in 2019 and 2020 (32%, n=8). They use Instagram tools: Stories (56%, n=14), bio (96%, n=24), highlights (96%, n=24). In the visual dimension, they use personal photos in the profile (68%, n=17); they have a brand or logo (100%, n=25); the visual identity is identified in most profiles (60%, n=15). They do not adopt sustainable positioning (96%, n=24). Regarding products, businesses offer a variety of products/services within their niches. With regard to pricing, participants may face challenges in effectively communicating their pricing. In the square aspect, positive aspects are observed, such as the provision of services outside their cities and the freight/delivery option. When it comes to promotion, businesses advertise, show sales force, engage with followers, and partner. CONCLUSION: In general, the profiles present several marketing strategies, and align with the classic concept of meeting the needs generating profit. It is concluded that basic but effective marketing strategies are already applied, a novelty would be to conduct these strategies as a series of interrelated events.