Ana Cristina de Oliveira e Silva

Spatial distribution of tuberculosis and relationship with living conditions in an urban area of Campina Grande - 2004 to 2007

This research aimed to study the spatial distribution of tuberculosis and its relationship with living conditions in the urban area of the city of Campina Grande in the period from 2004 until 2007. It is an ecologic study which used the citys neighborhood distribution; demographic, social and economic data from year 2000 census; and the new cases of tuberculosis reported to the Disease and Reporting Information System. Georeferencing was done for the cases of tuberculosis, and disease incidence was calculated by neighborhood. Rates were softened and the Global Moran Index was calculated. Social-economic data were grouped in quartiles according to the Life Condition Index, calculating the incidence of TB in each stratum of living conditions. The results showed that the spatial distribution of tuberculosis in the city is not uniform. Grouping neighborhoods according to the Life Conditions Index revealed social differences that can justify the occurrence of higher incidence rates in the most socially and economically vulnerable regions. The best living condition stratum presented a high incidence possibly due to the underreporting of the cases of tuberculosis caused mainly by the centralization of disease control services. We hope that this study may help outline control strategies for the city of Campina Grande, from the perspective of health promotion, for a disease so socially determined, as is the case of TB.

Quality of life, clinical characteristics and treatment adherence of people living with HIV/AIDS

Objetivos: evaluar la calidad de vida de las personas viviendo con VIH/Sida y sus asociaciones con caracteristicas clinicas y adhesion al tratamiento. Metodo: estudio transversal, realizado en un hospital del estado de Paraiba. Se utilizo un cuestionario para caracterizacion sociodemografica y clinica, la Escala de Calidad de Vida (propuesta por la Organizacion Mundial de la Salud) y la Escala de Adhesion al Tratamiento (Cuestionario para Evaluacion de la Adhesion al Tratamiento Antirretroviral). Resultados: de los 314 entrevistados, 190 (60,5%) eran del sexo masculino, edad promedio de 43 anos, 121(38,5%) contaban con hasta cinco anos de estudio, 108 (34,4%) recibian hasta dos salarios minimos y 112 (35,7%) no realizaban actividades laborales. En cuanto a las variables clinicas, se identifico que los individuos con carga viral indetectable presentaron mayores puntajes en todos los dominios de calidad de vida, con diferencia estadisticamente significativa en tres dominios. Sobre la adhesion al tratamiento, 235 (73,8%) presentaron adhesion insuficiente, los que presentaron adhesion estricta obtuvieron mejores puntajes de calidad de vida. Los resultados mostraron que la calidad de vida es mejor para los adherentes a la TARV. Apoyar a personas en tratamiento para mejorar la adhesion a los antirretrovirales debe ser una tarea constante de los profesionales de la salud y de otras personas que participan del tratamiento, como familiares y amigos.Descriptores: HIV; Sindrome de Inmunodeficiencia Adquirida; Calidad de Vida; Cumplimiento de la Medicacion.OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.

RISCOS OCUPACIONAIS: PERCEPÇÃO DE PROFISSIONAIS DE ENFERMAGEM DA ESTRATÉGIA SAÚDE DA FAMÍLIA EM JOÃO PESSOA – PB

Objective: To investigate the understanding of nursing staff of the family health units regarding occupational risks to which they are exposed, and to identify their suggestions in order to minimize such exposure. Material and Methods: This is a descriptive study with qualitative approach. We conducted interviews with 12 nurses from four units in Joao Pessoa, PB. Data were processed through the content analysis. Results: There were physical, chemical, biological and ergonomic risks along with accidents in the units. According to subjects’ reports, the risks occur due to the contact between professional and user, difficult for working in group, work routine, lack of protective equipment and resistant conduct of the workers themselves. Professionals pointed out to the need for education in health, improvement of working conditions, expansion of the number of professionals and use of personal protective equipment as a strategy to minimize exposure to occupational hazards. Conclusion: It was evident that nursing professionals have knowledge about risks to which they are exposed and suggest changes that can reduce these risks; such knowledge should be valued in the adoption of measures to promote care and maintenance of workers´ health. DESCRIPTORS: Occupational Risk. Nursing. Family Health.

Analysis of the physical aspects of quality of life of kidney recipients

OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.OBJETIVO Identificar os principais fatores do dominio fisico modificados apos transplante renal e analisar a influencia desses aspectos na percepcao de qualidade de vida (QV) geral. METODO Estudo longitudinal, desenvolvido com 63 pacientes renais cronicos, avaliados antes e apos transplante renal, utilizando a escala de qualidade de vida proposta pela Organizacao Mundial de Saude RESULTADOS Observou-se melhora significativa nos aspectos fisicos da QV depois do transplante renal. Correlacoes significativas foram observadas entre aspectos fisicos e a QV geral CONCLUSAO O transplante renal promoveu melhora em todos os aspectos fisicos da QV. Os fatores que apresentaram correlacao mais forte com a QV geral antes do transplante foram capacidade para o trabalho e dor. Depois da efetivacao do transplante, a percepcao sobre necessidade de tratamento foi o fator que apresentou correlacao mais forte com a QV geral.

Quality Of Life Of Women Living With HIV/AIDS

Objectives: to evaluate the quality of lifeof women withHIV/AIDSin the Stateof Paraiba anddefine them asthe socio-demographicprofile. Method: This was a descriptive, exploratory and quantitative study, conducted at the Hospital Clementino Fraga, had a population of 33 women with HIV / AIDS, using the form of interviews HATQoL, clinical and sociodemographic, data collection took place in July 2014 after approval of the CEP UFPB. Results and Discussion: There was concern domains with commitment of confidentiality, financial worry and sexual activity with a possible association with clinical and sociodemographic data obtained, most women: they are aged between 36-42 years acquired HIV through heterosexual sex, unmarried , have children (between 1-2), have low education (less than 9 years of schooling) and low income (up to two minimum wages). Conclusion: Therefore, it is necessary that the care of these women is conducted by interdisciplinary teams that promote integrated care, gazing beyond the individual needs, aspects related to their quality of life. In this perspective, the nurse plays a fundamental role in promoting quality of life. Keywords: Quality of life. Women. HIV. AIDS. Nursing.

Análise dos aspectos físicos da qualidade de vida de receptores de rim

OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL.OBJETIVO Identificar os principais fatores do dominio fisico modificados apos transplante renal e analisar a influencia desses aspectos na percepcao de qualidade de vida (QV) geral. METODO Estudo longitudinal, desenvolvido com 63 pacientes renais cronicos, avaliados antes e apos transplante renal, utilizando a escala de qualidade de vida proposta pela Organizacao Mundial de Saude RESULTADOS Observou-se melhora significativa nos aspectos fisicos da QV depois do transplante renal. Correlacoes significativas foram observadas entre aspectos fisicos e a QV geral CONCLUSAO O transplante renal promoveu melhora em todos os aspectos fisicos da QV. Os fatores que apresentaram correlacao mais forte com a QV geral antes do transplante foram capacidade para o trabalho e dor. Depois da efetivacao do transplante, a percepcao sobre necessidade de tratamento foi o fator que apresentou correlacao mais forte com a QV geral.

Calidad de vida, características clínicas y adhesión al tratamiento de personas viviendo con VIH/Sida

Objetivos: evaluar la calidad de vida de las personas viviendo con VIH/Sida y sus asociaciones con caracteristicas clinicas y adhesion al tratamiento. Metodo: estudio transversal, realizado en un hospital del estado de Paraiba. Se utilizo un cuestionario para caracterizacion sociodemografica y clinica, la Escala de Calidad de Vida (propuesta por la Organizacion Mundial de la Salud) y la Escala de Adhesion al Tratamiento (Cuestionario para Evaluacion de la Adhesion al Tratamiento Antirretroviral). Resultados: de los 314 entrevistados, 190 (60,5%) eran del sexo masculino, edad promedio de 43 anos, 121(38,5%) contaban con hasta cinco anos de estudio, 108 (34,4%) recibian hasta dos salarios minimos y 112 (35,7%) no realizaban actividades laborales. En cuanto a las variables clinicas, se identifico que los individuos con carga viral indetectable presentaron mayores puntajes en todos los dominios de calidad de vida, con diferencia estadisticamente significativa en tres dominios. Sobre la adhesion al tratamiento, 235 (73,8%) presentaron adhesion insuficiente, los que presentaron adhesion estricta obtuvieron mejores puntajes de calidad de vida. Los resultados mostraron que la calidad de vida es mejor para los adherentes a la TARV. Apoyar a personas en tratamiento para mejorar la adhesion a los antirretrovirales debe ser una tarea constante de los profesionales de la salud y de otras personas que participan del tratamiento, como familiares y amigos.Descriptores: HIV; Sindrome de Inmunodeficiencia Adquirida; Calidad de Vida; Cumplimiento de la Medicacion.OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.

Qualidade de vida, características clínicas e adesão ao tratamento de pessoas vivendo com HIV/AIDS

Objetivos: evaluar la calidad de vida de las personas viviendo con VIH/Sida y sus asociaciones con caracteristicas clinicas y adhesion al tratamiento. Metodo: estudio transversal, realizado en un hospital del estado de Paraiba. Se utilizo un cuestionario para caracterizacion sociodemografica y clinica, la Escala de Calidad de Vida (propuesta por la Organizacion Mundial de la Salud) y la Escala de Adhesion al Tratamiento (Cuestionario para Evaluacion de la Adhesion al Tratamiento Antirretroviral). Resultados: de los 314 entrevistados, 190 (60,5%) eran del sexo masculino, edad promedio de 43 anos, 121(38,5%) contaban con hasta cinco anos de estudio, 108 (34,4%) recibian hasta dos salarios minimos y 112 (35,7%) no realizaban actividades laborales. En cuanto a las variables clinicas, se identifico que los individuos con carga viral indetectable presentaron mayores puntajes en todos los dominios de calidad de vida, con diferencia estadisticamente significativa en tres dominios. Sobre la adhesion al tratamiento, 235 (73,8%) presentaron adhesion insuficiente, los que presentaron adhesion estricta obtuvieron mejores puntajes de calidad de vida. Los resultados mostraron que la calidad de vida es mejor para los adherentes a la TARV. Apoyar a personas en tratamiento para mejorar la adhesion a los antirretrovirales debe ser una tarea constante de los profesionales de la salud y de otras personas que participan del tratamiento, como familiares y amigos.Descriptores: HIV; Sindrome de Inmunodeficiencia Adquirida; Calidad de Vida; Cumplimiento de la Medicacion.OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.

Tuberculosis in the prison: control actions in terms of the detainees

ABSTRACT Objective : to analyze the actions to control TB in a Joao Pessoa-PB’s detention unity, the reports of detainees were used. Methodology : this is a qualitative study, performed with 13 detainees in treatment, after approval by the Ethics and Research Comitee of the Faculdade de Enfermagem Nova Esperanca, under protocol n. 039/07. Was chosen as the technique of semi-structured interview, using a voice recorder. The material was analyzed through the technique of content analysis, thematic modality. Result : the detainees reported that the principal actors involved in actions to control and treatment of TB are: the nursing staff, family, and is the most valued by them and prisoners who work in socio-educational activities to reduce penalty. The natural environment in the prison is violent and hostile actions favoring the gaps in control and in addition. The containment includes a greater number of weaknesses. Conclusion : the treatment is purely therapeutic consisting solely in drug intake, and yet, failing, featuring the interruption of treatment and promoting drug-resistant tuberculosis. Furthermore, professionals must be able to experience the unique culture of the place. Descriptors : tuberculosis, pulmonary; tuberculosis, multidrug-resistant; prisons. RESUMO Objetivo : analisar as acoes de controle da TB em uma unidade prisional de Joao Pessoa-PB, a partir de relatos dos detentos assistidos. Metodologia : estudo qualitativo, realizado com 13 detentos em tratamento, apos aprovacao do Comite de Etica e Pesquisa da Faculdade de Enfermagem Nova Esperanca, sob o protocolo de n. 039/07. Elegeu-se a tecnica de entrevista semiestruturada, utilizando um gravador de voz. O material foi analisado atraves da Tecnica de Analise de Conteudo, modalidade tematica. Resultado : os detentos relataram que os principais envolvidos nas acoes de controle e tratamento da TB, sao: a equipe de enfermagem; a familia, sendo que e a mais valorizada por eles e, os presos que atuam em atividades socioeducativas para reducao da pena. O ambiente natural do presidio e violento e hostil, favorecendo lacunas nas acoes de controle. Alem disso, o confinamento contempla um maior numero de fragilidades. Conclusao : o atendimento e puramente terapeutico consistindo unicamente na ingestao de medicamentos e, ainda sim, apresentando falhas, caracterizando a interrupcao do tratamento e favorecendo a tuberculose multirresistente. Alem disso, os profissionais devem ser capacitados para vivenciar a cultura propria do local. Descritores : tuberculose pulmonar; tuberculose resistente a multiplos medicamentos; prisoes. RESUMEN Objetivo : analizar las acciones de control de la tuberculosis en una prision de Joao Pessoa, en Paraiba, desde los relatos de los reclusos atendidos. Metodologia : estudio cualitativo, hecho con 13 reclusos en tratamiento, despues de la aprobacion del Comite de Etica en Investigacion de la Faculdade de Enfermagem Nova Esperanca, proceso 039/07. La entrevista fue semiestructurada, utilizando una grabadora de voz. El material fue analizado mediante la tecnica de Analisis de Contenido, una modalidad tematica. Resultado : l os reclusos relataron que los principales envueltos en las acciones de control y tratamiento de la tuberculosis son: el equipo de enfermeria; la familia, siendo esta la mas valorada por ellos, y los reclusos que hacen actividades socio-educativas para reduccion del riesgo. El medio ambiente natural en el presidio es violento y hostil, favoreciendo el surgimiento de lagunas en las acciones de control y, tambien, el confinamiento contempla un mayor numero de fragilidades. C onclusion : el atendimiento es solo terapeutico y consiste solamente en la ingestion de medicamentos, pero presenta fallas, caracterizando la interrupcion del tratamiento y favoreciendo la tuberculosis multi-resistente. Ademas, los profesionales deben ser capaces de lidiar con la cultura propia del lugar. Descriptores : tuberculosis pulmonar; tuberculosis resistente a multiples medicamentos; prisiones.