Gehysa Guimarães Alves

As práticas educativas em saúde e a Estratégia Saúde da Família

Este trabalho tem por objetivo refletir sobre a educacao em saude, enfatizando a educacao popular em saude (EPS) como proposta metodologica e sua utilizacao na rede basica de saude, em especial na Estrategia Saude da Familia. Para tanto, foi realizada revisao bibliografica sobre educacao em saude, pratica educativa nos servicos de saude e educacao popular em saude. Observou-se que, ainda hoje, as praticas educativas nos servicos de saude obedecem a metodologias tradicionais, nao privilegiando a criacao de vinculo entre trabalhadores e populacao. Para que a educacao popular em saude possa se consolidar como uma pratica educativa, deve ser incorporada no cotidiano do trabalho em saude. Nesse sentido, a formacao profissional deve valorizar as acoes coletivas promotoras da saude e desencadear um processo de reflexao critica nos sujeitos envolvidos nas relacoes de ensino-aprendizagem

Family psychosocial characteristics, tobacco, alcohol, and other drug use, and teenage pregnancy

The aim of this study was to analyze associations between demographic factors, family psychosocial characteristics, tobacco, alcohol, and other drug use, and adolescent motherhood. This was a case-control study in Porto Alegre, Rio Grande do Sul State, Brazil, with 431 adolescents 14 to 16 years of age who gave birth in 2009 (cases) and 862 adolescents who had never given birth (controls). Three-stage hierarchical logistic regression was performed (demographic, family psychosocial, and lifestyle variables). Lower economic class, not having lived with the parents from 10 to 14 years of age (OR = 1.67; 95%CI: 1.12-2.48), having taken care of other children (OR = 1.42; 95%CI: 1.09-1.87), siblings who had children before 20 years of age (OR = 1.56; 95%CI: 1.192.06), having tried smoking (OR = 1.94; 95%CI: 1.35-2.78), and having arrived home intoxicated (OR = 1.67; 95%CI: 1.12-2.48) were associated with adolescent motherhood. Greater attention should be given to family relations in association with tobacco and alcohol consumption, since the use of these substances is associated with adolescent motherhood.O objetivo foi estudar a associacao entre fatores demograficos, caracteristicas psicossociais familiares, uso de tabaco, alcool e outras drogas e a gravidez na adolescencia. Estudo de casocontrole com 431 adolescentes, com idades entre 14 e 16 anos, de Porto Alegre, Rio Grande do Sul, Brasil, que tiveram filhos em 2009 (casos), e 858 adolescentes sem filhos (controles). A regressao logistica hierarquica foi realizada em tres etapas (variaveis demograficas, variaveis psicossociais familiares e variaveis de estilo de vida). A menor insercao economica, nao ter morado com os pais entre 10 e 14 anos (RC = 1,67; IC95%: 1,12-2,48), experiencia no cuidado de criancas (RC = 1,42; IC95%: 1,09-1,87), irmaos que tiveram filhos antes dos 20 anos (RC = 1,56; IC95%: 1,19-2,06), experimentacao de tabaco (RC = 1,94; IC95%: 1,35-2,78) e ja ter chegado em casa embriagada (RC = 1,67; IC95%: 1,12-2,48) associaram-se a gravidez na adolescencia. Maior atencao deve ser dada as relacoes familiares em relacao ao consumo de tabaco e alcool, considerando que o uso destas substâncias se associam a gravidez na adolescencia.

Sentimento de discriminação em estudantes: prevalência e fatores associados

OBJETIVO: Estimar a prevalencia e fatores associados ao sentimento de discriminacao entre estudantes. METODOS: Estudo transversal com amostra representativa de 1.170 escolares de um total de 2.282 matriculados na setima serie do ensino fundamental em escolas municipais de Gravatai (RS), em 2005. Os participantes foram selecionados por amostragem aleatoria por conglomerado. Os dados foram obtidos com instrumentos auto-aplicados (Global School-based Student Health Survey, body shape questionnaire, classificacao socioeconomica) preenchidos em sala de aula. Foi utilizada a regressao de Cox modificada para estudos transversais, segundo modelo hierarquizado em quatro etapas. RESULTADOS: A prevalencia de sentimento de discriminacao foi de 21,0%, mais prevalente entre: as meninas (RP=1,93, IC 95% 1,51;2,46); os que apresentaram absenteismo escolar (RP=1,54, IC 95% 1,21;1,97); os que fizeram uso na vida de tabaco (RP=1,53, IC 95% 1,18;1,98); os preocupados com sua imagem corporal (RP=1,42, IC 95% 1,07;1,88); os com sentimento de solidao (RP=2,50, IC 95% 1,80;3,46) e tristeza (RP=1,29, IC 95% 1,02;1,62); os com dificuldade para dormir (RP:1,41, IC 95% 1,08;1,83); os com ideacao suicida (RP=1,45, IC 95% 1,13;1,85) e os que sofreram algum tipo de injuria acidental (RP=1,56, IC 95% 1,23;1,97) ou intencional (RP=2,04, IC 95% 1,51;2,76). CONCLUSOES: O sentimento de discriminacao esteve associado ao sexo e a experiencia com tabaco. Sua associacao com fatores psicossociais indica a coexistencia de situacoes adversas, como a insatisfacao com a imagem corporal, sintomas depressivos e presenca de injurias. Esses resultados mostram a importância da atuacao conjunta de professores e profissionais de saude na identificacao precoce desse sentimento, orientacao e acompanhamento de jovens enfrentando essas situacoes.OBJECTIVE To estimate the prevalence of and factors associated with feelings of discrimination among students. METHODS Cross-sectional study with a representative sample of 1,170 students from a total of 2,282 students enrolled in the 7th grade of an elementary school of the city of Gravataí, Southern Brazil, in 2005. Participants were selected by conglomerate random sampling. Data were obtained from self-applied instruments (Global School-based Student Health Survey, Body Shape Questionnaire, socioeconomic classification) that were completed in the classroom. Cox regression, modified for cross-sectional studies, was employed, according to a four-stage hierarchical model. RESULTS Prevalence of feelings of discrimination was 21.0%. These feelings were more prevalent among: girls (PR=1.93, 95% CI 1.51;2.46); those showing school absenteeism (PR=1.54, 95% CI 1.21;1.97); those who had used tobacco in their lives (PR=1.53, 95% CI 1.18;1.98); those concerned about their body image (PR=1.42, 95% CI 1.07;1.88); those with feelings of loneliness (PR=2.50, 95% CI 1.80;3.46) and sadness (PR=1.29, 95% CI 1.02;1.62); those with sleep difficulties (PR:1.41, 95% CI 1.08;1.83); those with suicidal ideation (PR=1.45, 95% CI 1.13;1.85) and those who had suffered some type of accidental (PR=1.56, 95% CI 1.23;1.97) or intentional injury (PR=2.04, 95% CI 1.51;2.76). CONCLUSIONS Feelings of discrimination were associated with sex and experience with tobacco. Its association with psychosocial factors indicates the coexistence of adverse situations, such as dissatisfaction with body image, depressive symptoms and presence of insults. These findings show the importance of health professionals and teachers acting together to identify these feelings early on, and guide and follow adolescents facing such situations.

[Feelings of discrimination among students: prevalence and associated factors].

OBJETIVO: Estimar a prevalencia e fatores associados ao sentimento de discriminacao entre estudantes. METODOS: Estudo transversal com amostra representativa de 1.170 escolares de um total de 2.282 matriculados na setima serie do ensino fundamental em escolas municipais de Gravatai (RS), em 2005. Os participantes foram selecionados por amostragem aleatoria por conglomerado. Os dados foram obtidos com instrumentos auto-aplicados (Global School-based Student Health Survey, body shape questionnaire, classificacao socioeconomica) preenchidos em sala de aula. Foi utilizada a regressao de Cox modificada para estudos transversais, segundo modelo hierarquizado em quatro etapas. RESULTADOS: A prevalencia de sentimento de discriminacao foi de 21,0%, mais prevalente entre: as meninas (RP=1,93, IC 95% 1,51;2,46); os que apresentaram absenteismo escolar (RP=1,54, IC 95% 1,21;1,97); os que fizeram uso na vida de tabaco (RP=1,53, IC 95% 1,18;1,98); os preocupados com sua imagem corporal (RP=1,42, IC 95% 1,07;1,88); os com sentimento de solidao (RP=2,50, IC 95% 1,80;3,46) e tristeza (RP=1,29, IC 95% 1,02;1,62); os com dificuldade para dormir (RP:1,41, IC 95% 1,08;1,83); os com ideacao suicida (RP=1,45, IC 95% 1,13;1,85) e os que sofreram algum tipo de injuria acidental (RP=1,56, IC 95% 1,23;1,97) ou intencional (RP=2,04, IC 95% 1,51;2,76). CONCLUSOES: O sentimento de discriminacao esteve associado ao sexo e a experiencia com tabaco. Sua associacao com fatores psicossociais indica a coexistencia de situacoes adversas, como a insatisfacao com a imagem corporal, sintomas depressivos e presenca de injurias. Esses resultados mostram a importância da atuacao conjunta de professores e profissionais de saude na identificacao precoce desse sentimento, orientacao e acompanhamento de jovens enfrentando essas situacoes.OBJECTIVE To estimate the prevalence of and factors associated with feelings of discrimination among students. METHODS Cross-sectional study with a representative sample of 1,170 students from a total of 2,282 students enrolled in the 7th grade of an elementary school of the city of Gravataí, Southern Brazil, in 2005. Participants were selected by conglomerate random sampling. Data were obtained from self-applied instruments (Global School-based Student Health Survey, Body Shape Questionnaire, socioeconomic classification) that were completed in the classroom. Cox regression, modified for cross-sectional studies, was employed, according to a four-stage hierarchical model. RESULTS Prevalence of feelings of discrimination was 21.0%. These feelings were more prevalent among: girls (PR=1.93, 95% CI 1.51;2.46); those showing school absenteeism (PR=1.54, 95% CI 1.21;1.97); those who had used tobacco in their lives (PR=1.53, 95% CI 1.18;1.98); those concerned about their body image (PR=1.42, 95% CI 1.07;1.88); those with feelings of loneliness (PR=2.50, 95% CI 1.80;3.46) and sadness (PR=1.29, 95% CI 1.02;1.62); those with sleep difficulties (PR:1.41, 95% CI 1.08;1.83); those with suicidal ideation (PR=1.45, 95% CI 1.13;1.85) and those who had suffered some type of accidental (PR=1.56, 95% CI 1.23;1.97) or intentional injury (PR=2.04, 95% CI 1.51;2.76). CONCLUSIONS Feelings of discrimination were associated with sex and experience with tobacco. Its association with psychosocial factors indicates the coexistence of adverse situations, such as dissatisfaction with body image, depressive symptoms and presence of insults. These findings show the importance of health professionals and teachers acting together to identify these feelings early on, and guide and follow adolescents facing such situations.

Uso de álcool, tabaco e outras drogas por adolescentes escolares de Porto Velho-RO, Brasil

OBJETIVO: estudiar la prevalencia y factores asociados al uso de tabaco, alcohol y otras drogas. METODO: estudio transversal con adolescentes escolares de la red estadual de ensenanza de Porto Velho-RO, Brasil; se investigaron las asociaciones mediante la regresion de Cox multivariante, calculadas las razones de prevalencia (RP) e intervalos de confianza de 95% (IC95%). RESULTADOS: la prevalencia del consumo de alcohol, tabaco y otras drogas fue de 24,0%, 6,4% y 2,3% respectivamente; el uso de alcohol se asocio al consumo de tabaco (RP 6,68; IC95% 3,17-14,10; p<0,001), uso de drogas ilicitas (RP 4,34; IC95% 1,28-14,76; p=0,010) y al consumo de alcohol por los padres (RP 1,52; IC95% 1,14-2,02; p<0,001); el consumo de tabaco por los padres y amigos y el uso de otras drogas por los amigos estuvieron asociados al consumo de esas substancias por los estudiantes. CONCLUSION: se evidencia la necesidad de involucrar a la escuela y a la familia en acciones dirigidas a la prevencion del uso de esas substancias entre adolescentes.

The aging process and health: what middle-aged people think of the issue

Objective To understand the perception of middle-aged adults regarding health and the aging process. Method A qualitative study involving 30 adults aged 45 to 59 years old, 15 of whom were female and 15 of whom were male, who answered open questions about their perception of health and aging. Data was analyzed using the thematic content analysis technique. Results Almost half of the respondents had not finished elementary school and only three had a university degree. A total of 27 were married, five were retired and 25 worked in the service provider sector, 26 were Caucasian, and 27 belonged to social-economic class B. The perception of health was described as being related to taking care of oneself (physical, mental and spiritual welfare), to being active and having the will to live. Regarding aging, the middle-aged persons had already begun to perceive signs of this process such as slowness to perform daily tasks, fatigue, muscle pain, rheumatic pain, a slowing of weight loss, gray hair, impaired vision and hearing, difficulty performing some movements, marks on skin and forgetfulness. Regarding protective actions, the practicing of physical activity, a healthy diet, social and family life and having some sort of occupation were mentioned. The greatest desire was to reach an older age with good health, independence and good living conditions. Conclusion Although the data of the present study cannot be generalized, it is an important starting point for future research, since the results reveal concerns that can be reduced to support programs of healthy aging.Objective: To understand the perception of middle-aged adults regarding health and the aging process. Method: A qualitative study involving 30 adults aged 45 to 59 years old, 15 of whom were female and 15 of whom were male, who answered open questions about their perception of health and aging. Data was analyzed using the thematic content analysis technique. Results: Almost half of the respondents had not finished elementary school and only three had a university degree. A total of 27 were married, five were retired and 25 worked in the service provider sector, 26 were Caucasian, and 27 belonged Palavras-chave: Saúde; Envelhecimento; Meia Idade. http://dx.doi.org/10.1590/1809-9823.2016.14122

Predictors of Physical Activity and Sports and Their Influence on the Wellbeing of Adolescents

The present study aimed to assess whether contextual influences on practice of physical activity and sports among adolescents – as it is the case of practice of sports by important people in their lives, encouragement to playing sports from important people in their lives, the importance of and reasons for playing sports among adolescents, and their intention to play sports in the future – predict psychological wellbeing and life satisfaction in this population, and whether effective practice of physical activity and sports by adolescents work as a mediating variable in these relations. This study involved 3.396 school-aged adolescents from Southern Brazil. The instruments adopted were: the block on physical activity and practice of sports of The Health Behavior in School-aged Children (HBSC) survey; the General Health Questionnaire (GHQ-12), for psychological wellbeing assessment; and the Overall Life Satisfaction (OLS). The results, obtained by means of hierarchical linear regression analysis, confirmed the hypotheses that effective practice of physical activity and sports by adolescents operates as a mediator between the influences on practice of physical activity/sports among adolescents, psychological wellbeing and life satisfaction. These results show that, with respect to practice of physical activity/sports in adolescence, contextual influences are important for psychological wellbeing and life satisfaction. However, effective practice of physical activity/sports should be encouraged and implemented in a variety of possible contexts in the life of adolescents as a strategy towards the promotion of this population’s quality of life.

Discriminant analyzes for the use of tobacco, alcohol and other drugs among adolescents in an urban center in southern Brazil

Introduction : The consumption of tobacco, alcohol, and illicit drugs is a problem in adolescence, especially in the school context. This study aimed to identify the demographic and social variables that distinguished the students who had used tobacco, alcohol and/or other drugs at some point of their lives from those who had never used these substances. Methods : A school-based cross-sectional study was conducted to evaluate students attending the ninth year of elementary education in the city of Caxias do Sul (n = 1,285). Results : Alcohol was the most consumed drug (74.9%). In all the three discriminant profiles, adolescents who used tobacco throughout their lives presented more family conflict and hierarchy, higher age, greater difficulty in talking to their mother, father, and siblings, and higher school failure rates. The group that reported lifetime use of alcohol showed similar characteristics, and also reported greater loneliness. The group that has used illicit drugs was characterized, as well as other factors, by meeting with friends outside school more often, not having a good friend, being lonely, and having difficulties in talking to their father. Conclusion : Several social and family-related aspects can act as factors that propitiate adolescents from drugs. Public policies in this regard are of fundamental importance. Keywords : Adolescents; use of drugs; family; discriminant analysis

Fatherhood in Adolescence: A Qualitative Study on the Experience of Being an Adolescent Father

The present study, descriptive case series, deals with the theme of teenage parenthood. The objective was to apprehend the phenomenon of teenage parenthood through the trajectory of the parents, their perceptions and experience, as well as their life projects compared with adolescents who are not parents, aged between 14 and 20 years. For each case selected, another young man at the same age who was not a parent was sought in the same neighborhood. Thirty adolescent parents participated in the study and other 30 adolescents who were not parents. The instrument consisted of closed questions about: socio-demographic characteristics and economic classification. A semi-structured interview addressed: sexual life, teenage pregnancy, meaning of parenthood during adolescence, experience of parenting in adolescence, life projects before and after paternity and message to other teenagers who were not parents. The quantitative variables were obtained through descriptive statistics. The interview questions were analyzed by using the technique of thematic content analysis. The profile of the teenage parents revealed low economic class, low education and high levels of school truancy, with financial responsibility and cohabitation with the mother of the baby. In most cases, the responsibility for contraception is placed on the woman. In few cases the pregnancy was planned. Although the assessment of the experience is predominantly negative, parents point out positive aspects of the experience of parenthood, always emphasizing the increased responsibility and the change in their lifestyle as a teenager. The results point to the need for consideration of the teenage parents for an understanding of the phenomenon of teenage pregnancy.

Características psicossociais familiares e uso de tabaco, álcool e outras drogas relacionadas à gravidez na adolescência

The aim of this study was to analyze associations between demographic factors, family psychosocial characteristics, tobacco, alcohol, and other drug use, and adolescent motherhood. This was a case-control study in Porto Alegre, Rio Grande do Sul State, Brazil, with 431 adolescents 14 to 16 years of age who gave birth in 2009 (cases) and 862 adolescents who had never given birth (controls). Three-stage hierarchical logistic regression was performed (demographic, family psychosocial, and lifestyle variables). Lower economic class, not having lived with the parents from 10 to 14 years of age (OR = 1.67; 95%CI: 1.12-2.48), having taken care of other children (OR = 1.42; 95%CI: 1.09-1.87), siblings who had children before 20 years of age (OR = 1.56; 95%CI: 1.192.06), having tried smoking (OR = 1.94; 95%CI: 1.35-2.78), and having arrived home intoxicated (OR = 1.67; 95%CI: 1.12-2.48) were associated with adolescent motherhood. Greater attention should be given to family relations in association with tobacco and alcohol consumption, since the use of these substances is associated with adolescent motherhood.O objetivo foi estudar a associacao entre fatores demograficos, caracteristicas psicossociais familiares, uso de tabaco, alcool e outras drogas e a gravidez na adolescencia. Estudo de casocontrole com 431 adolescentes, com idades entre 14 e 16 anos, de Porto Alegre, Rio Grande do Sul, Brasil, que tiveram filhos em 2009 (casos), e 858 adolescentes sem filhos (controles). A regressao logistica hierarquica foi realizada em tres etapas (variaveis demograficas, variaveis psicossociais familiares e variaveis de estilo de vida). A menor insercao economica, nao ter morado com os pais entre 10 e 14 anos (RC = 1,67; IC95%: 1,12-2,48), experiencia no cuidado de criancas (RC = 1,42; IC95%: 1,09-1,87), irmaos que tiveram filhos antes dos 20 anos (RC = 1,56; IC95%: 1,19-2,06), experimentacao de tabaco (RC = 1,94; IC95%: 1,35-2,78) e ja ter chegado em casa embriagada (RC = 1,67; IC95%: 1,12-2,48) associaram-se a gravidez na adolescencia. Maior atencao deve ser dada as relacoes familiares em relacao ao consumo de tabaco e alcool, considerando que o uso destas substâncias se associam a gravidez na adolescencia.