Graziella Lage Oliveira

Homens, vítimas e autores de violência: a corrosão do espaço público e a perda da condição humana

Trata-se de estudo qualitativo, realizado no Municipio de Ribeirao das Neves-MG, com o objetivo de compreender o envolvimento dos homens com a violencia. A metodologia consistiu de grupos focais organizados segundo sexo, faixa etaria e regiao administrativa do Municipio, sendo, ao todo, trinta grupos, com 231 participantes, recrutados aleatoriamente. Para analisar, foi utilizado o metodo hermeneutico-dialetico e, a luz da teoria politica de Hannah Arendt, a violencia foi interpretada como dominacao que perpassa as relacoes humanas. Homens e mulheres foram identificados como possiveis autores e vitimas de violencia, o envolvimento de cada um sendo definido a partir de relacoes desiguais que estabelecem. Os numeros da violencia, assim como as explicacoes centradas em teorias biologicas, podem levar a conclusao prematura de que os homens sejam mais violentos do que as mulheres. A fundamentacao teorica e a contextualizacao mais profundas permitem clarear outras faces desse importante problema.

Satisfação de médicos com o cuidado às doenças cardiovasculares em municípios de Minas Gerais: Escala Cardiosatis-EQUIPE

OBJECTIVE To evaluate psychometric validity and reliability properties of the CARDIOSATIS-Team scale and measure physician satisfaction before and after the implementation of the project. This scale was designed to evaluate physician satisfaction with the healthcare delivered for cardiovascular diseases in cities that participate in a telemedicine system. METHODS The scale was applied in 82 cities of Minas Gerais, before and after the implementation of a telecardiology system. The analysis of the psychometric properties of CARDIOSATIS-Team scale included: construct validity using factorial analysis; internal consistency reliability using Cronbachs Alpha; Pearsons correlation between items; Spearmans correlation between domains and global scale and; discriminant analysis. RESULTS The factor analysis of the principal components extracted two factors that explained 66.5% of the variance in satisfaction scores: healthcare delivery and diagnosis structure and satisfaction with the care delivered. Cronbachs Alfa for internal consistency reliability of the scale showed values of 0.92 for the global scale and up to 0.84 for factors. Inter-factor and inter-scale correlations were adequate, showing values of 0.59 to 0.89 and 0.73 to 0.85, respectively. The scale was able to distinguish the two moments of its application (before and after intervention), showing high satisfaction for most items measured afterwards (p < 0.05). CONCLUSIONS We can conclude based on the present study that the telemedicine system improved provider satisfaction and that the CARDIOSATIS-Team scale is a good tool to evaluate provider satisfaction with care delivered for CVD. Its appropriate characteristics in terms of validity and internal consistency reliability justify its utilization in other studies.

Avaliação da completitude das notificações compulsórias relacionadas ao trabalho registradas por município polo industrial no Brasil, 2007 - 2011

OBJECTIVE To analyze the completeness of workers health problems notification fields registered in a Brazilian municipal industrial hub in the period from January 1st, 2007 to December 31st, 2011. METHODS Descriptive study based on secondary data and composed of all records related to work (n = 2,345 ) in the National Disease Notification System, using criteria recommended by the Guidelines for Evaluating Public Health Surveillance Systems created by the Center for Disease Control and Prevention. The completeness of the fields present in the research and report forms was assessed by the percentage of filled fields, the Spearman correlation coefficient and graphical analysis. RESULTS In most of the essential fields it was identified a decrease in the percentage of filling (n = 18; 64%). The degree of completeness of compulsory fields was high (> 85%); most of the non-discriminated fields were 0 - 25% filled; there were variable indexes for key fields (0 - 98%). Considerable variability was observed in the completeness of the key fields, having three variables with significant negative correlation (rs = -0.9; p = 0.0347). Only one variable showed significant positive correlation. CONCLUSION The quality of most of the stored data was classified as regular to excellent for important variables on the design of worker health and surveillance actions. However, we recommend routine quality data assessments in workers health information systems in the Unified Health System.OBJECTIVE: To analyze the completeness of workers health problems notification fields registered in a Brazilian municipal industrial hub in the period from January 1st, 2007 to December 31st, 2011. METHODS: Descriptive study based on secondary data and composed of all records related to work (n = 2,345 ) in the National Disease Notification System, using criteria recommended by the Guidelines for Evaluating Public Health Surveillance Systems created by the Center for Disease Control and Prevention. The completeness of the fields present in the research and report forms was assessed by the percentage of filled fields, the Spearman correlation coefficient and graphical analysis. RESULTS: In most of the essential fields it was identified a decrease in the percentage of filling (n = 18; 64%). The degree of completeness of compulsory fields was high (> 85%); most of the non-discriminated fields were 0 - 25% filled; there were variable indexes for key fields (0 - 98%). Considerable variability was observed in the completeness of the key fields, having three variables with significant negative correlation (rs = -0.9; p = 0.0347). Only one variable showed significant positive correlation. CONCLUSION: The quality of most of the stored data was classified as regular to excellent for important variables on the design of worker health and surveillance actions. However, we recommend routine quality data assessments in workers health information systems in the Unified Health System.

Accidentes de trabajo fatales y violencia interpersonal en Brasil, 2000-2010

In this study, we present estimates of the proportionate mortality of work injuries involving interpersonal violence in Brazil from 2000 to 2010. Data come from the Mortality Information System based on death certificates from the Health Ministry, which in Brazil include a field for recording work-related injuries that must be completed in all deaths due to external causes. There were 1,368,732 deaths due to external causes, 31,576 (2.3%) due to work injuries, and only 226 (0.02%) due to work injuries involving interpersonal violence. Nearly 80% of the death certificates did not include data in the work injury field. Most cases occurred among males (94.3%) 25-34 years of age with less than high school education in the Southeast and Northeast country regions, primarily in the manufacturing and agricultural industries. The majority of cases were caused by firearms, followed by sharp instruments, with a relative increase in this last category during the study period. Findings suggest underrecording of diagnoses that recognize the work-related nature of the death. Better training on death certificate completion and studies to quantify the underrecording of work injuries and work injuries involving interpersonal violence are needed.In this study, we present estimates of the proportionate mortality of work injuries involving interpersonal violence in Brazil from 2000 to 2010. Data come from the Mortality Information System based on death certificates from the Health Ministry, which in Brazil include a field for recording work-related injuries that must be completed in all deaths due to external causes. There were 1,368,732 deaths due to external causes, 31,576 (2.3%) due to work injuries, and only 226 (0.02%) due to work injuries involving interpersonal violence. Nearly 80% of the death certificates did not include data in the work injury field. Most cases occurred among males (94.3%) 25-34 years of age with less than high school education in the Southeast and Northeast country regions, primarily in the manufacturing and agricultural industries. The majority of cases were caused by firearms, followed by sharp instruments, with a relative increase in this last category during the study period. Findings suggest underrecording of diagnoses that recognize the work-related nature of the death. Better training on death certificate completion and studies to quantify the underrecording of work injuries and work injuries involving interpersonal violence are needed.

Saúde mental e a continuidade do cuidado em centros de saúde de Belo Horizonte, MG

OBJETIVO: Analisar os fatores associados a continuidade do cuidado em saude mental de pacientes encaminhados a centros de saude. METODOS: Foi conduzido um estudo de seguimento de 98 pacientes encaminhados a oito centros de saude com equipe de saude mental da area de abrangencia de um centro de referencia a saude mental, em Belo Horizonte, MG, atendidos entre 2003 e 2004. Variaveis sociodemograficas, clinicas e referentes a continuidade foram descritas e em seguida comparadas, utilizando o teste do qui-quadrado. RESULTADOS: Apos o encaminhamento, 35 pacientes nao compareceram para o primeiro atendimento nos centros de saude. Dos que o fizeram, 38 continuaram em tratamento. Retornar ao centro de referencia para nova consulta apos o encaminhamento e ter tido mais de dois encaminhamentos foram fatores facilitadores da continuidade do cuidado. Nenhuma caracteristica individual esteve associada a continuidade. CONCLUSOES: Os achados sugerem haver uma falha na proposta da linha de cuidado. A continuidade do tratamento parece estar mais relacionada a fatores referentes ao servico do que a caracteristicas do paciente.

Mental health and continuity of care in healthcare centers in a city of Southeastern Brazil

OBJETIVO: Analisar os fatores associados a continuidade do cuidado em saude mental de pacientes encaminhados a centros de saude. METODOS: Foi conduzido um estudo de seguimento de 98 pacientes encaminhados a oito centros de saude com equipe de saude mental da area de abrangencia de um centro de referencia a saude mental, em Belo Horizonte, MG, atendidos entre 2003 e 2004. Variaveis sociodemograficas, clinicas e referentes a continuidade foram descritas e em seguida comparadas, utilizando o teste do qui-quadrado. RESULTADOS: Apos o encaminhamento, 35 pacientes nao compareceram para o primeiro atendimento nos centros de saude. Dos que o fizeram, 38 continuaram em tratamento. Retornar ao centro de referencia para nova consulta apos o encaminhamento e ter tido mais de dois encaminhamentos foram fatores facilitadores da continuidade do cuidado. Nenhuma caracteristica individual esteve associada a continuidade. CONCLUSOES: Os achados sugerem haver uma falha na proposta da linha de cuidado. A continuidade do tratamento parece estar mais relacionada a fatores referentes ao servico do que a caracteristicas do paciente.

Propriedades psicométricas da Vulnerability to Abuse Screening Scale para rastreio de abuso contra idosos

ABSTRACT OBJECTIVE Adapt and evaluate the psychometric properties of the Vulnerability to Abuse Screening Scale to identify risk of domestic violence against older adults in Brazil. METHODS The instrument was adapted and validated in a sample of 151 older adults from a geriatric reference center in the municipality of Belo Horizonte, State of Minas Gerais, in 2014. We collected sociodemographic, clinical, and abuse-related information, and verified reliability by reproducibility in a sample of 55 older people, who underwent re-testing of the instrument seven days after the first application. Descriptive and comparative analyses were performed for all variables, with a significance level of 5%. The construct validity was analyzed by the principal components method with a tetrachoric correlation matrix, the reliability of the scale by the weighted Kappa (Kp) statistic, and the internal consistency by the Kuder-Richardson estimator formula 20 (KR-20). RESULTS The average age of the participants was 72.1 years (DP = 6.96; 95%CI 70.94–73.17), with a maximum of 92 years, and they were predominantly female (76.2%; 95%CI 69.82–83.03). When analyzing the relationship between the scores of the Vulnerability to Abuse Screening Scale, categorized by presence (score > 3) or absence (score < 3) of vulnerability to abuse, with clinical and health conditions, we found statistically significant differences for self-perception of health (p = 0.002), depressive symptoms (p = 0.000), and presence of rheumatism (p = 0.003). There were no statistically significant differences between sexes. The Vulnerability to Abuse Screening Scale acceptably evaluated validity in the transcultural adaptation process, demonstrating dimensionality coherent with the original proposal (four factors). In the internal consistency analysis, the instrument presented good results (KR-20 = 0.69) and the reliability via reproducibility was considered excellent for the global scale (Kp = 0.92). CONCLUSIONS The Vulnerability to Abuse Screening Scale proved to be a valid instrument with good psychometric capacity for screening domestic abuse against older adults in Brazil.

Integralidade, condições de oferta de serviços e processo de trabalho de Equipes de Saúde da Família em Belo Horizonte

RESUMO Busca-se analisar a relacao entre acoes de integralidade e as condicoes de oferta dos servicos, alem do processo de trabalho das Equipes de Saude da Familia, em centros de saude de um distrito de Belo Horizonte (MG). E um estudo transversal com questionario autoaplicavel. Ao todo, 538 profissionais participaram do estudo. Foram realizadas analises descritivas e comparativas, por meio do qui-quadrado de Pearson, e de um valor -p=0,05 para verificacao da significância estatistica. Tanto as condicoes de oferta dos servicos quanto o processo de trabalho se mostraram associados a realizacao de acoes de integralidade, sendo que o planejamento se mostrou a ferramenta mais importante para a realizacao de tais atividades.

Men, victims and perpetrators of violence: the corrosion of public space and the loss of the human condition

Trata-se de estudo qualitativo, realizado no Municipio de Ribeirao das Neves-MG, com o objetivo de compreender o envolvimento dos homens com a violencia. A metodologia consistiu de grupos focais organizados segundo sexo, faixa etaria e regiao administrativa do Municipio, sendo, ao todo, trinta grupos, com 231 participantes, recrutados aleatoriamente. Para analisar, foi utilizado o metodo hermeneutico-dialetico e, a luz da teoria politica de Hannah Arendt, a violencia foi interpretada como dominacao que perpassa as relacoes humanas. Homens e mulheres foram identificados como possiveis autores e vitimas de violencia, o envolvimento de cada um sendo definido a partir de relacoes desiguais que estabelecem. Os numeros da violencia, assim como as explicacoes centradas em teorias biologicas, podem levar a conclusao prematura de que os homens sejam mais violentos do que as mulheres. A fundamentacao teorica e a contextualizacao mais profundas permitem clarear outras faces desse importante problema.

Hombres, víctimas y perpetradores de la violencia: la corrosión del espacio público y la pérdida de la condición humana

Trata-se de estudo qualitativo, realizado no Municipio de Ribeirao das Neves-MG, com o objetivo de compreender o envolvimento dos homens com a violencia. A metodologia consistiu de grupos focais organizados segundo sexo, faixa etaria e regiao administrativa do Municipio, sendo, ao todo, trinta grupos, com 231 participantes, recrutados aleatoriamente. Para analisar, foi utilizado o metodo hermeneutico-dialetico e, a luz da teoria politica de Hannah Arendt, a violencia foi interpretada como dominacao que perpassa as relacoes humanas. Homens e mulheres foram identificados como possiveis autores e vitimas de violencia, o envolvimento de cada um sendo definido a partir de relacoes desiguais que estabelecem. Os numeros da violencia, assim como as explicacoes centradas em teorias biologicas, podem levar a conclusao prematura de que os homens sejam mais violentos do que as mulheres. A fundamentacao teorica e a contextualizacao mais profundas permitem clarear outras faces desse importante problema.