Camila Teixeira Moreira Vasconcelos

Knowledge, attitude and practice related to the pap smear test among users of a primary health unit

Este e um estudo tipo inquerito CAP (conhecimento, atitude e pratica), realizado no periodo de fevereiro a junho de 2008, no qual se objetivou avaliar o conhecimento, a atitude e a pratica do exame colpocitologico entre usuarias de uma unidade basica de saude (UBS) e verificar sua associacao com variaveis sociodemograficas. A amostra foi composta por 250 mulheres. O conhecimento, a atitude e a pratica sobre o exame foram adequados em 40,4, 28 e 67,6% das entrevistadas, respectivamente. Os resultados encontrados evidenciaram proporcoes mais altas de conhecimento e atitude adequados com escolaridade (>;9 anos) e idade (>;35 anos). E essencial buscar respostas especificas a respeito dessa problematica, a fim de direcionar acoes integradas de educacao em saude, garantindo, assim, o maior acesso, adesao e retorno das mulheres ao exame.This KAP (knowledge, attitude and practice) study, carried out from February to June 2008, aimed to evaluate the knowledge, attitude and practice regarding the Pap smear test among users of a primary health unit (PHU) and to verify any association with sociodemographic variables. The sample was comprised of 250 women. The knowledge, attitude and practice related to the examination were adequate in 40.4%, 28% and 67.6% of respondents, respectively. The results demonstrate higher proportions of adequate knowledge and attitude with schooling (>9 years) and age (>35 years). It is essential to seek specific answers regarding this issue in order to direct integrated actions of health education, thus ensuring greater access, adhesion and return of the women for the examination results.

Quality of life of Brazilian women with urinary incontinence and the impact on their sexual function

INTRODUCTION AND OBJECTIVE Sexual function may be affected in women with urinary incontinence (UI), but data regarding this association are controversial. The aim of this study was to assess the impact of sociodemographic characteristics in the sexual function of Brazilian women with UI. STUDY DESIGN Cross-sectional study with 251 women with UI in the period from April to June 2014. Firstly, sociodemographic and pelvic floor dysfunctions (PFD) characteristics were compared between groups of women with and without sexual activity. Secondly, we compared the variables above with the total score of Pelvic Organ Prolapse and/or Urinary Incontinence Sexual Questionnaire (PISQ-12). For continuous variables, we used the Mann-Whitney or Kruskal-Wallis test; for categorical variables we used the chi-square statistic considering the difference of p<0.05. RESULTS Women with sexual activity tend to be younger, to be premenopausal, have a steady partner and not be hypertensive. The mean total score of PISQ-12 was 27.30. Women who attended elementary school, with coital UI, with moderate constipation and symptomatic prolapse have worse sexual function. Premenopausal women with mixed urinary incontinence have worse sexual function than those with stress urinary incontinence. CONCLUSION The association between sexual dysfunction and UI deserves special attention from health professionals. The care of the maintenance or restoration of sexual well-being should be offered to all women, regardless of age, since UI may affect sexual life and QoL of these women.

Integrative review of the nursing interventions used for the early detection of cervical uterine cancer

In a national program to combat cervical uterine cancer (CUC) four basic elements should exist: primary prevention, early detection, diagnosis/treatment and palliative care. Of these, early detection is the most effective modality. One of the purposes of Evidence-Based Practice (EBP) is to encourage the use of research results with the assistance provided, reinforcing the importance of research for clinical practice. This study aimed to evaluate the evidence available in the literature regarding effective nursing interventions for the early detection of CUC. The selection of articles was performed in the databases: Scopus, PubMed, CINAHL, Lilacs and Cochrane. The sample of this review consisted of seven articles, with evidence levels 1, 2 or 3. The behavioral, cognitive and social interventions, showed positive effects in the early detection of CUC, especially the interactive cognitive interventions. It is suggested, when appropriate, to use a combination of interventions in order to obtain a more effective result.En un programa nacional de combate al cancer cervicouterino (CCU) deben existir cuatro elementos basicos: prevencion primaria, deteccion precoz, diagnostico/tratamiento y cuidados paliativos. De estos, la deteccion precoz es la modalidad mas efectiva. Uno de los propositos de la Practica Basada en Evidencias es incentivar la utilizacion de resultados de investigacion junto a la asistencia prestada, reforzando la importancia de la investigacion para la practica clinica. Este estudio objetivo evaluar las evidencias disponibles en la literatura sobre las intervenciones de enfermeria eficaces en la deteccion precoz del CCU. La seleccion de los articulos fue realizada en las bases: Scopus, Pubmed, CINAHL, LILACS y Cochrane. La muestra de esta revision se constituye de 7 articulos, con niveles de evidencia 1, 2 o 3. Tanto las intervenciones comportamentales, como las cognitivas y sociales mostraron efectos positivos en la deteccion precoz del CCU, con destaque para las intervenciones cognitivas interactivas. Se sugiere, cuando adecuado, utilizar una combinacion de las intervenciones para obtener un resultado mas eficaz.

Fatores de risco para câncer de colo do útero segundo resultados de IVA, citologia e cervicografia

Este estudio objetivo evaluar la asociacion entre factores de riesgo para cancer de cuello de utero y lesiones cervicales por HPV, segun comparacion entre los resultados de la inspeccion visual con acido acetico (IVA), citologia y cervicografia. Se realizo investigacion de prevalencia, con 157 mujeres en un centro de salud de Fortaleza-CE-Brasil, en el periodo de junio a setiembre de 2006. Se utilizo el SPSS para codificar los datos. Se realizaron inferencias a traves de tests estadisticos (χ2 = Qui-cuadrado y RV= razon de verosimilitud). La IVA, cervicografia y citologia obtuvieron 43,3%, 10,19% y 3,2% de resultados alterados. Las variables con importante asociacion a lesiones cervicales en la IVA fueron: edad menor a 20 anos (p=0,0001), uno o mas parejas en los ultimos tres meses (p=0,015), uso de anti-conceptivos (p=0,0008), presencia de vaginitis (p=0,0001) y pH elevado (p=0,001). No se encontro asociacion significativa en la cervicografia.

Conhecimento, atitude e prática relacionada ao exame colpocitológico entre usuárias de uma unidade básica de saúde

Este e um estudo tipo inquerito CAP (conhecimento, atitude e pratica), realizado no periodo de fevereiro a junho de 2008, no qual se objetivou avaliar o conhecimento, a atitude e a pratica do exame colpocitologico entre usuarias de uma unidade basica de saude (UBS) e verificar sua associacao com variaveis sociodemograficas. A amostra foi composta por 250 mulheres. O conhecimento, a atitude e a pratica sobre o exame foram adequados em 40,4, 28 e 67,6% das entrevistadas, respectivamente. Os resultados encontrados evidenciaram proporcoes mais altas de conhecimento e atitude adequados com escolaridade (>;9 anos) e idade (>;35 anos). E essencial buscar respostas especificas a respeito dessa problematica, a fim de direcionar acoes integradas de educacao em saude, garantindo, assim, o maior acesso, adesao e retorno das mulheres ao exame.This KAP (knowledge, attitude and practice) study, carried out from February to June 2008, aimed to evaluate the knowledge, attitude and practice regarding the Pap smear test among users of a primary health unit (PHU) and to verify any association with sociodemographic variables. The sample was comprised of 250 women. The knowledge, attitude and practice related to the examination were adequate in 40.4%, 28% and 67.6% of respondents, respectively. The results demonstrate higher proportions of adequate knowledge and attitude with schooling (>9 years) and age (>35 years). It is essential to seek specific answers regarding this issue in order to direct integrated actions of health education, thus ensuring greater access, adhesion and return of the women for the examination results.

Factors related to failure to attend the consultation to receive the results of the Pap smear test

Objective to identify the factors related to the failure of women to attend the follow-up consultation to receive the results of the Pap smear test. Method a cross-sectional study, carried out with 775 patients who underwent the Pap smear test in the Centro de Saúde da Família of Fortaleza, between September 2010 and February 2011. Results the majority of the women studied were young (≤35 years), had low levels of education (≤7 years of study), and commenced sexual activity early (≤20 years), with 17.0% of them failing to return to receive the test results. Statistically significant results for the failure to return were related to: young women (p=0.001); early onset of sexual activity (p=0.047); and inadequate knowledge about the Pap smear test (p=0.029). Conclusion the fact that the women failed to return for the result is a problem for the control of cervical cancer and must be addressed through educational strategies that reinforce the importance of the return for the early detection of this cancer.OBJETIVO: identificar los factores relacionados a la no asistencia de las mujeres a la consulta de retorno para recibir el resultado de la prueba de Papanicolaou. METODO: se trata de un estudio transversal, realizado con 775 pacientes que se sometieron a la prueba de Papanicolaou en el Centro de Salud de la Familia de Fortaleza-CE, entre septiembre de 2010 y febrero de 2011. RESULTADOS: la mayoria de las encuestadas eran jovenes (≤35 anos), de baja escolaridad (≤7 anos de estudio), iniciaron la vida sexual muy temprano (≤20 anos) y 17,0% de ellas no retornaron para recibir el resultado del examen. Los resultados estadisticamente significativos por no retornar estuvieron relacionados a: mujeres jovenes (p=0,001); inicio precoz de la actividad sexual (p=0,047); y conocimiento inadecuado sobre la prueba de Papanicolaou (p=0,029). CONCLUSION: el hecho de la mujer no retornar para recibir el resultado es un problema para el control del cancer de cuello uterino y debe ser combatido por medio de estrategias educativas que refuercen la importancia del retorno para la deteccion precoz de ese cancerOBJECTIVE: to identify the factors related to the failure of women to attend the follow-up consultation to receive the results of the Pap smear test. METHOD: a cross-sectional study, carried out with 775 patients who underwent the Pap smear test in the Centro de Saude da Familia of Fortaleza, between September 2010 and February 2011. RESULTS: the majority of the women studied were young (≤35 years), had low levels of education (≤7 years of study), and commenced sexual activity early (≤20 years), with 17.0% of them failing to return to receive the test results. Statistically significant results for the failure to return were related to: young women (p=0.001); early onset of sexual activity (p=0.047); and inadequate knowledge about the Pap smear test (p=0.029). Conclusion the fact that the women failed to return for the result is a problem for the control of cervical cancer and must be addressed through educational strategies that reinforce the importance of the return for the early detection of this cancer.

Analysis of coverage and of the pap test exams not retired of a Basic Health Unit

To analyze the coverage and the colpocytology exams that were not collected from a Health Center. This is a retrospective documentary study, in which the data were evaluated for coverage of 2007 and all 225 tests that were performed but were not collected by the patients unit until January 2008. Statistical analysis was performed using the frequency of the studied variables. The average monthly number of tests was 102.6 examinations. The coverage of the examination in 2007 was 11.22% among women with 25 to 59 years of age. Of the 938 tests conducted between February and November 2007, 225 (23.98%) women did not receive the result. Most women (67.5%) who performed the examination and had not returned were 30 years old or younger. The womens attitude of not returning to collect their exam results increases the difficulty of follow up, and providing comprehensive and continuity of care, contributing with an intervention in advanced stages of the disease.To analyze the coverage and the colpocytology exams that were not collected from a Health Center. This is a retrospective documentary study, in which the data were evaluated for coverage of 2007 and all 225 tests that were performed but were not collected by the patients unit until January 2008. Statistical analysis was performed using the frequency of the studied variables. The average monthly number of tests was 102.6 examinations. The coverage of the examination in 2007 was 11.22% among women with 25 to 59 years of age. Of the 938 tests conducted between February and November 2007, 225 (23.98%) women did not receive the result. Most women (67.5%) who performed the examination and had not returned were 30 years old or younger. The womens attitude of not returning to collect their exam results increases the difficulty of follow up, and providing comprehensive and continuity of care, contributing with an intervention in advanced stages of the disease.

Análise da cobertura e dos exames colpocitológicos não retirados de uma Unidade Básica de Saúde

To analyze the coverage and the colpocytology exams that were not collected from a Health Center. This is a retrospective documentary study, in which the data were evaluated for coverage of 2007 and all 225 tests that were performed but were not collected by the patients unit until January 2008. Statistical analysis was performed using the frequency of the studied variables. The average monthly number of tests was 102.6 examinations. The coverage of the examination in 2007 was 11.22% among women with 25 to 59 years of age. Of the 938 tests conducted between February and November 2007, 225 (23.98%) women did not receive the result. Most women (67.5%) who performed the examination and had not returned were 30 years old or younger. The womens attitude of not returning to collect their exam results increases the difficulty of follow up, and providing comprehensive and continuity of care, contributing with an intervention in advanced stages of the disease.To analyze the coverage and the colpocytology exams that were not collected from a Health Center. This is a retrospective documentary study, in which the data were evaluated for coverage of 2007 and all 225 tests that were performed but were not collected by the patients unit until January 2008. Statistical analysis was performed using the frequency of the studied variables. The average monthly number of tests was 102.6 examinations. The coverage of the examination in 2007 was 11.22% among women with 25 to 59 years of age. Of the 938 tests conducted between February and November 2007, 225 (23.98%) women did not receive the result. Most women (67.5%) who performed the examination and had not returned were 30 years old or younger. The womens attitude of not returning to collect their exam results increases the difficulty of follow up, and providing comprehensive and continuity of care, contributing with an intervention in advanced stages of the disease.

Comparison of three algorithms for prediction preeclampsia in the first trimester of pregnancy

OBJECTIVE To compare a new simple algorithm for preeclampsia (PE) prediction among Brazilian women with two international guidelines - National Institute for Clinical Excellence (NICE) and American College of Obstetricians and Gynecologists (ACOG). METHODS We performed a secondary analysis of two prospective cohort studies to predict PE between 11 and 13+6weeks of gestation, developed between August 2009 and January 2014. Outcomes measured were total PE, early PE (<34weeks), preterm PE (<37weeks), and term PE (≥37weeks). The predictive accuracy of the models was assessed using the area under the receiver operator characteristic curve (AUC-ROC) and via calculation of sensitivity and specificity for each outcome. RESULTS Of a total of 733 patients, 55 patients developed PE, 12 at early, 21 at preterm and 34 at term. The AUC-ROC values were low, which compromised the accuracy of NICE (AUC-ROC: 0.657) and ACOG (AUC-ROC: 0.562) algorithms for preterm PE prediction in the Brazilian population. The best predictive model for preterm PE included maternal factors (MF) and mean arterial pressure (MAP) (AUC-ROC: 0.842), with a statistically significant difference compared with ACOG (p<0.0001) and NICE (p=0.0002) guidelines. CONCLUSION The predictive accuracies of NICE and ACOG guidelines to predict preterm PE were low and a simple algorithm involving maternal factors and MAP performed better for the Brazilian population.

Simple approach based on maternal characteristics and mean arterial pressure for the prediction of preeclampsia in the first trimester of pregnancy

Abstract Aim: To propose a simple model for predicting preeclampsia (PE) in the 1st trimester of pregnancy on the basis of maternal characteristics (MC) and mean arterial pressure (MAP). Methods: A prospective cohort was performed to predict PE between 11 and 13+6 weeks of gestation. The MC evaluated were maternal age, skin color, parity, previous PE, smoking, family history of PE, hypertension, diabetes mellitus and body mass index (BMI). Mean arterial blood pressure (MAP) was measured at the time of the 1st trimester ultrasound. The outcome measures were the incidences of total PE, preterm PE (delivery <37 weeks) and term PE (delivery ≥37 weeks). We performed logistic regression analysis to determine which factors made significant contributions for the prediction of the three outcomes. Results: We analyzed 733 pregnant women; 55 developed PE, 21 of those developed preterm PE and 34 term PE. For total PE, the best model was MC+MAP, which had an area under the receiver operating characteristic curve (AUC ROC) of 0.79 [95% confidence interval (CI)=0.76–0.82]. For preterm PE, the best model was MC+MAP, with an AUC ROC of 0.84 (95% CI=0.81–0.87). For term PE, the best model was MC, with an AUC ROC of 0.75 (0.72–0.79). The MC+MAP model demonstrated a detection rate of 67% cases of preterm PE, with a false-positive rate of 10%, positive predictive value of 17% and negative predictive value of 99%. Conclusion: The MC+MAP model showed good accuracy in predicting preterm PE in the 1st trimester of gestation.