Líliam Barbosa Silva

Cut-off point for WHOQOL-bref as a measure of quality of life of older adults

OBJECTIVE To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults. METHODS Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults’ quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory – good or very good self-reported quality of life and being satisfied or very satisfied with health – G5; and poor/very poor quality of life – poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health – G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref. RESULTS ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6). CONCLUSIONS Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health.

OFICINAS SOBRE SEXUALIDADE NA ADOLESCÊNCIA: REVELANDO VOZES, DESVELANDO OLHARES DE ESTUDANTES DO ENSINO MÉDIO

Se trata de investigacion con los adolescentes de una escuela estatal del distrito municipal al Norte de Minas Gerais - Brasil con el objetivo de entender como ellos viven y ellos ejercen su sexualidad. El estudio se desarrollo por los talleres ludico-pedagogicos en el acercamiento cualitativo. El punto de los resultados que el concepto de sexualidad se limita a las relaciones sexuales entre dos personas de sexo opuesto. Los estudiantes dieron enfasis al riesgo de un embarazo no deseado y reconocieron la importancia del uso de metodos anticoncepcionales. Los talleres propiciaron una atmosfera favorable para la discusion de cambios de actitud para los adolescentes por la informacion, reflexion y expresion de ideas y sentimientos, representando un proceso a ser complementado por la familia, escuela y politica sociales locales.

O teatro em foco: estratégia lúdica para o trabalho educativo na saúde da família

Resumen Se informa sobre la experiencia de los estudiantes de enfermería que utilizaron el teatro como estrategia lúdica para el trabajo educativo con equipos de Salud de la Familia. Se realizó el Diagnóstico Situacional de Salud en el interior del Estado de Minas Gerais; las morbidades más prevalentes se emplearon como temás por tratar en las parodias. En tres meses se escribieron nueve parodias para un público diversificado. Se observó una ruptura en el cotidiano de la comunidad porque, en la dimensión lúdica, el personas dejaron fluir el aspecto placentero de la vida, decodificando el mundo a su manera, una mezcla agradable de arte y ciencia. El teatro permitió vislumbrar las distintas aplicaciones en Salud de la Familia: como estrategia lúdica eficaz para adquirir conceptos de salud, como recurso de ocio y como espacio de convivencia. Habría que promover capacitación de multiplicadores en la comunidad para que continúen armando talleres de teatro en prol de la construcción del conocimiento colectivo. Palabras clave: Educación en Salud. Promoción de la Salud. Programa de Salud Familiar. Creatividad. Enfermería. 1Doutora em Saúde Pública. Docente do Departamento de Enfermagem Básica da Escola de Enfermagem da Universidade Federal de Minas Gerais – EEUFMG. Coordenadora do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano da EEUFMG Belo Horizonte-MG. Brasil. Email: smsoares.bhz@terra.com.br; 2Mestre em Enfermagem pela EEUFMG. Servidora pública da Prefeitura Municipal de Betim/MG. Membro do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano da EEUFMG Belo Horizonte-MG. Brasil. Email: ligemeasbh@yahoo.com.br; 3 Enfermeira. Mestranda da EEUFMG. Membro do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano da EEUFMG Belo Horizonte-MG. Brasil. Email: patriciaaparecidabarbosasilva@yahoo.com.br RELATO DE EXPERIÊNCIA EXPERIENCE REPORT EXPERIENCIA DE INFORME It reports on the experience of nursing students who used the theatre as a ludic strategy for the educational work with family healthcare teams. A Situational Health Diagnosis was completed in the State of Minas Gerais inland. Its more frequent illnesses were used then as arguments to be addressed in the scenes. In three months nine acts were written and performed for a varied audience. We observed a rupture in the community daily routine in which, under a ludic dimension , the people allowed the flowing of a more pleasant side of life and interpreted the world their own way in an agreeable combination of art and science. This experience in drama therapy allowed us to witness its many uses in the context of Family Healthcare. It constitutes a valuable ludic strategy for the acquisition of health concepts, an effective leisure alternative and a get together space. It is necessary however to train community agents so they would be able to carry on the organization of theatre workshops towards the construction of a collective knowledge.It reports on the experience of nursing students who used the theatre as a ludic strategy for the educational work with family healthcare teams. A Situational Health Diagnosis was completed in the State of Minas Gerais inland. Its more frequent illnesses were used then as arguments to be addressed in the scenes. In three months nine acts were written and performed for a varied audience. We observed a rupture in the community daily routine in which, under a ludic dimension , the people allowed the flowing of a more pleasant side of life and interpreted the world their own way in an agreeable combination of art and science. This experience in drama therapy allowed us to witness its many uses in the context of Family Healthcare. It constitutes a valuable ludic strategy for the acquisition of health concepts, an effective leisure alternative and a get together space. It is necessary however to train community agents so they would be able to carry on the organization of theatre workshops towards the construction of a collective knowledge.

Comunicação sazonal sobre a dengue em grupos socioeducativos na atenção primária à saúde

OBJETIVO: Analizar como se establece la comunicacion estacional en los grupos socioeducativos de los equipos de Salud de la Familia para prevencion y control del dengue. PROCEDIMIENTOS METODOLOGICOS: Estudio cualitativo, descriptivo y exploratorio con 25 coordinadores de grupos socioeducativos, distribuidos en ocho unidades basicas de salud de Belo Horizonte, Sureste de Brasil. La colecta de datos ocurrio de marzo a julio de 2009, por medio de observacion no participante y entrevista semi-estructurada con los coordinadores. En la interpretacion de los datos, se emplearan analisis de contenido y los referenciales teoricos sobre la comunicacion y salud. ANALISIS DE LOS RESULTADOS: Se encontraron tres nucleos tematicos: comunicacion estacional; contenidos discutidos y canales vehiculadores de informaciones sobre el dengue; e informacion versus comunicacion para la accion. Las acciones de prevencion y control del dengue en los grupos eran abordadas principalmente en epocas de surto, basandose en acciones previamente programadas por el Ministerio de la Salud. Los temas abordados se referian a epidemiologia, ciclo de vida, modos de transmision, sintomatologia, prevencion, visita domiciliar del equipo de zoonosis y vacunacion contra el dengue. CONCLUSIONES: La practica comunicativa predominante es el repase de informaciones por el coordinador, centrado en el discurso comportamentalista y prescriptivo. Se recomiendan practicas comunicativas pautadas en el dialogo, permitiendo al coordinador y miembros del equipo la libertad con relacion a las situaciones emergentes del grupo y que aprendan a reconocerla y problematizarla reflexivamente en su contexto.OBJECTIVE To analyze how seasonal communication for dengue control and prevention is conveyed in educational peer groups of Family Health teams. METHODOLOGICAL PROCEDURES An exploratory and descriptive qualitative study was performed with 25 coordinators of peer education groups, distributed among eight basic health units of Belo Horizonte, Southeastern Brazil. Data collection occurred from March to June 2009, by non-participant observation and semi-structured interviews with coordinators. Content analysis and the principal theories in health communication were utilized in data interpretation. ANALYSIS OF RESULTS Three thematic units were identified: seasonal communication; subjects discussed and information sources about dengue; and information versus communication for action. Dengue prevention and control actions were principally discussed in groups during outbreaks, based on actions previously programmed by the Ministry of Health. The topics addressed focused on epidemiology, life cycle, modes of transmission, symptoms, prevention, domiciliary visits by zoonosis control units and vaccination for dengue. CONCLUSIONS The predominant communication action is information conveyance by the coordinator, centered on a behavioralist and prescriptive discourse. Communication practices focused on dialogue is recommended, allowing the coordinator and group members freedom in regards to emergent issues in the group, so they learn to recognize and reflexively discuss them in context.

A utilização da música nas atividades educativas em grupo na Saúde da Família

OBJECTIVE describe how music is used in the development of group educational activity in Family Health. METHODS a qualitative, descriptive and exploratory study, developed with 10 group coordinators, distributed in five basic care units in Belo Horizonte, Minas Gerais, Brazil. Data were collected from March to July, 2009, with non participant observation in the group itself, and semi-structured interviews with the coordinators. Information was organized and categorized according to thematic analysis. To interpret the data, the Snyderian concepts in addition to theoretical references about music, communication and health education were used. RESULTS three thematic nuclei were found: the affective dimension of music; recreative dimension of music and the reflexive dimension of music. CONCLUSION an attempt by the coordinators was observed, to overcome the pathological barriers with the use of music, considering the group as a whole. As advancement for the production of knowledge, this study shows the need for qualification of these coordinators, by means of workshops and constant follow-up of their musical practices.Objetivo: describir como la musica es utilizada en el desarrollo de actividad educativa en grupo en la Salud de la Familia. Metodos: estudio cualitativo, descriptivo y exploratorio, efectuado con 10 coordinadores de grupos, distribuidos en cinco unidades basicas de Belo Horizonte, Minas Gerais. Los datos fueron recolectados de marzo a julio de 2009, con observacion no participante en el propio grupo y entrevista semiestructurada con los coordinadores. Las informaciones fueron organizadas y categorizadas segun el analisis tematico. Para interpretacion de los datos se utilizo, ademas de los marcos teoricos sobre musica, comunicacion y educacion en salud, las concepciones de Snyders. Resultados: fueron encontrados tres nucleos tematicos: la dimension afectiva de la musica; la dimension recreativa de la musica; y la dimension reflexiva de la musica. Conclusion: se observo la intencion de los coordinadores de transponer las barreras de lo patologico a partir del uso de la musica, considerando al grupo en su totalidad. Este estudio considera un avance, para la produccion del conocimiento, la necesidad de capacitar esos coordinadores por medio de talleres y acompanamiento constante de sus practicas musicales.

The use of music in group educational activities in Family Health.

OBJECTIVE describe how music is used in the development of group educational activity in Family Health. METHODS a qualitative, descriptive and exploratory study, developed with 10 group coordinators, distributed in five basic care units in Belo Horizonte, Minas Gerais, Brazil. Data were collected from March to July, 2009, with non participant observation in the group itself, and semi-structured interviews with the coordinators. Information was organized and categorized according to thematic analysis. To interpret the data, the Snyderian concepts in addition to theoretical references about music, communication and health education were used. RESULTS three thematic nuclei were found: the affective dimension of music; recreative dimension of music and the reflexive dimension of music. CONCLUSION an attempt by the coordinators was observed, to overcome the pathological barriers with the use of music, considering the group as a whole. As advancement for the production of knowledge, this study shows the need for qualification of these coordinators, by means of workshops and constant follow-up of their musical practices.Objetivo: describir como la musica es utilizada en el desarrollo de actividad educativa en grupo en la Salud de la Familia. Metodos: estudio cualitativo, descriptivo y exploratorio, efectuado con 10 coordinadores de grupos, distribuidos en cinco unidades basicas de Belo Horizonte, Minas Gerais. Los datos fueron recolectados de marzo a julio de 2009, con observacion no participante en el propio grupo y entrevista semiestructurada con los coordinadores. Las informaciones fueron organizadas y categorizadas segun el analisis tematico. Para interpretacion de los datos se utilizo, ademas de los marcos teoricos sobre musica, comunicacion y educacion en salud, las concepciones de Snyders. Resultados: fueron encontrados tres nucleos tematicos: la dimension afectiva de la musica; la dimension recreativa de la musica; y la dimension reflexiva de la musica. Conclusion: se observo la intencion de los coordinadores de transponer las barreras de lo patologico a partir del uso de la musica, considerando al grupo en su totalidad. Este estudio considera un avance, para la produccion del conocimiento, la necesidad de capacitar esos coordinadores por medio de talleres y acompanamiento constante de sus practicas musicales.

Workshops on sexuality in adolescence: revealing voices, unveiling views student's of the medium teaching glances

Se trata de investigacion con los adolescentes de una escuela estatal del distrito municipal al Norte de Minas Gerais - Brasil con el objetivo de entender como ellos viven y ellos ejercen su sexualidad. El estudio se desarrollo por los talleres ludico-pedagogicos en el acercamiento cualitativo. El punto de los resultados que el concepto de sexualidad se limita a las relaciones sexuales entre dos personas de sexo opuesto. Los estudiantes dieron enfasis al riesgo de un embarazo no deseado y reconocieron la importancia del uso de metodos anticoncepcionales. Los talleres propiciaron una atmosfera favorable para la discusion de cambios de actitud para los adolescentes por la informacion, reflexion y expresion de ideas y sentimientos, representando un proceso a ser complementado por la familia, escuela y politica sociales locales.

Avaliação do cuidado primário à pessoa idosa segundo o Chronic Care Model

Objective: to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes. Method: cross-sectional study involving 105 older people with diabetes mellitus and/or hypertension. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used to evaluate the quality of care. The total score was compared with care outcomes that included biochemical parameters, body mass index, pressure levels and quality of life. Data analysis was based on descriptive statistics and multiple logistic regression. Results: there was a predominance of females and a median age of 72 years. The median PACIC score was 1.55 (IQ 1.30-2.20). Among the PACIC dimensions, the “delivery system design/decision support” was the one that presented the best result. There was no statistical difference between the medians of the overall PACIC score and individual care outcomes. However, when the quality of life and health satisfaction were simultaneously evaluated, a statistical difference between the medians was observed. Conclusion: the low PACIC scores found indicate that chronic care according to the CCM in the PHC seems still to fall short of its assumptions.ABSTRACT Objective: to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes. Method: cross-sectional study involving 105 older people with diabetes mellitus and/or hypertension. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used to evaluate the quality of care. The total score was compared with care outcomes that included biochemical parameters, body mass index, pressure levels and quality of life. Data analysis was based on descriptive statistics and multiple logistic regression. Results: there was a predominance of females and a median age of 72 years. The median PACIC score was 1.55 (IQ 1.30-2.20). Among the PACIC dimensions, the “delivery system design/decision support” was the one that presented the best result. There was no statistical difference between the medians of the overall PACIC score and individual care outcomes. However, when the quality of life and health satisfaction were simultaneously evaluated, a statistical difference between the medians was observed. Conclusion: the low PACIC scores found indicate that chronic care according to the CCM in the PHC seems still to fall short of its assumptions.

La utilización de la música en actividades educativas en grupo en la Salud de la Familia

OBJECTIVE describe how music is used in the development of group educational activity in Family Health. METHODS a qualitative, descriptive and exploratory study, developed with 10 group coordinators, distributed in five basic care units in Belo Horizonte, Minas Gerais, Brazil. Data were collected from March to July, 2009, with non participant observation in the group itself, and semi-structured interviews with the coordinators. Information was organized and categorized according to thematic analysis. To interpret the data, the Snyderian concepts in addition to theoretical references about music, communication and health education were used. RESULTS three thematic nuclei were found: the affective dimension of music; recreative dimension of music and the reflexive dimension of music. CONCLUSION an attempt by the coordinators was observed, to overcome the pathological barriers with the use of music, considering the group as a whole. As advancement for the production of knowledge, this study shows the need for qualification of these coordinators, by means of workshops and constant follow-up of their musical practices.Objetivo: describir como la musica es utilizada en el desarrollo de actividad educativa en grupo en la Salud de la Familia. Metodos: estudio cualitativo, descriptivo y exploratorio, efectuado con 10 coordinadores de grupos, distribuidos en cinco unidades basicas de Belo Horizonte, Minas Gerais. Los datos fueron recolectados de marzo a julio de 2009, con observacion no participante en el propio grupo y entrevista semiestructurada con los coordinadores. Las informaciones fueron organizadas y categorizadas segun el analisis tematico. Para interpretacion de los datos se utilizo, ademas de los marcos teoricos sobre musica, comunicacion y educacion en salud, las concepciones de Snyders. Resultados: fueron encontrados tres nucleos tematicos: la dimension afectiva de la musica; la dimension recreativa de la musica; y la dimension reflexiva de la musica. Conclusion: se observo la intencion de los coordinadores de transponer las barreras de lo patologico a partir del uso de la musica, considerando al grupo en su totalidad. Este estudio considera un avance, para la produccion del conocimiento, la necesidad de capacitar esos coordinadores por medio de talleres y acompanamiento constante de sus practicas musicales.

Communication in the coordination practices of socioeducational groups in family health

Se objetivo revelar la forma de comunicacion del coordinador de grupos socioeducativos en la Salud de la Familia. Investigacion cualitativa, descriptiva, exploratoria, desarrollada con 25 coordinadores de grupos distribuidos en ocho unidades basicas de salud de Belo Horizonte-Brasil. Datos recolectados por intervencion no participante y entrevista semiestructurada con los coordinadores. Se utilizaron como marco teorico las concepciones de Bakhtin y referenciales sobre comunicacion y salud. Las informaciones muestran que la triada cuerpo, salud y enfermedad es comunicada en los grupos por diferentes canales y en tres niveles diversificados de discurso. Se concluye en que hay necesidad de que el coordinador de valga de un abordaje que valorice la expresion del participante, no estrictamente de la salud en su dimension fisica, y si de la vida de cada uno, buscando diferentes formas de comunicacion para hacer efectiva la accion educativa dialogica y los espacios de interaccion en los grupos.The purpose of this study was to assess the forms of communication used by coordinators in socioeducational groups in family health programmes. This qualitative, descriptive and exploratory study was conducted with 25 coordinators of groups in eight basic health units from Belo Horizonte, Brazil. Data collection comprised non-participant observation and semistructured interviews with the coordinators. The theoretical basis for research was Bakhtins formulations and references on communication and health. The gathered information showed that the body, health and disease triad was communicated in groups through different channels and at different levels of discourse. Our conclusion is that coordinators must adopt an approach that values the expression of participants, not just regarding the physical dimensions of health, but also the life of each participant, and should use various forms of communication to foster dialogical educational actions and means for interaction in groups.