Lorena Teresinha Consalter Geib

Determinantes sociais da saúde do idoso

Health is affected throughout the course of life by characteristics of social context, which produce inequalities in terms of exposure and vulnerability. These social determinants interfere with the well-being, functional independence and quality of life of the elderly, but are generally overlooked in interventions and policies. Therefore, the aim of this study was to systematize the knowledge of the social determinants of health in the elderly, using the Dahlgren and Whitehead model as a conceptual guide. The effects of demographic changes in the aging process and morbidity profile were approached at the structural level. The conditions of life and work with impact on current and future health and the role of social cohesion were studied at the intermediate level. Lastly, the behavior and lifestyles of major risk were examined at close quarters. It was detected that equity in health requires attention to social determinants during the course of life in order to minimize chronic diseases and deficiencies of the elderly, which reflect their social positions in early life.A saude e afetada ao longo da vida pelas caracteristicas do contexto social, que geram desigualdades nas exposicoes e vulnerabilidades. Esses determinantes sociais interferem no bem-estar, independencia funcional e qualidade de vida dos idosos, mas geralmente sao desconsiderados nas intervencoes e politicas. Diante disso, objetivou-se sistematizar os conhecimentos acerca dos determinantes sociais da saude do idoso, adotando-se como marco conceitual o modelo de Dahlgren e Whitehead. No nivel estrutural, abordaram-se os efeitos das mudancas demograficas no processo de envelhecimento e perfil de morbidade; no nivel intermediario, as condicoes de vida e trabalho com impacto na saude atual e futura e o papel da coesao social; no nivel proximal, os comportamentos e estilos de vida de maior risco. Evidenciou-se que a equidade em saude requer acao sobre os determinantes sociais no curso da vida para minimizar as doencas cronicas e deficiencias do idoso que refletem as suas posicoes sociais no passado.

The incidence of sudden death syndrome in a cohort of infants.

OBJECTIVES To quantify the incidence of sudden infant death syndrome in the town of Passo Fundo, in Rio Grande do Sul, Brazil, and to describe the profile of the deaths observed. METHODS A population-based cohort study of the live births from February 2003 to January 2004 to parents resident in the urban area. Infants were excluded if they had been hospitalized since birth, were in the process of being adopted or had died before data collection. 2,411 children were included from the total of 2,634 live births and 2,285 (94.8%) of these were followed-up. Data were obtained from the Live Births Information System (Sistema de Informações Sobre Nascidos Vivos), death registers, records of the Committee on Infant Mortality and from interviews with the social mother during home visits. Data collection instruments were adapted from previously validated forms. Data were analyzed on Epi-Info with descriptive statistics. RESULTS Ten deaths were registered (0.4%). Four deaths of unknown causes could be included in sudden infant death syndrome category III. These deaths took place at home, between 4 and 6 months of age. The children slept on their sides, sharing a bed with adults, and had soft mattresses, pillows and diapers on the surface. They were the children of young mothers, smokers, with incomplete prenatal care and previous births from underprivileged economic classes. The incidence of suspicion of this syndrome was 1.75/1,000. CONCLUSION The incidence rate of suspected sudden infant death syndrome in Passo Fundo is comparable with the highest international coefficients, which suggests the need for vigilance and risk prevention measures.

Representações sociais das primíparas adolescentes sobre o cuidado materno ao recém-nascido

This qualitative study aimed to analyze the social representation of teenagers who had their first child and about maternal care to newborns in the home environment. Participants were eight teenagers with their newborns. Data were collected at their homes by means of projective techniques and semi-structured interviews. Analysis was based on social representation theory, demonstrating that the teenagers represent maternal care in figurative centers of affection, family integration and maternal fulfillment. The maternal care is symbolically anchored in the appearance of a family, in the continuum of feelings and in the commitment to the psychomotor progress of the child. The teenagers who had their first child gave more value to belonging to a family than to the losses resulting from early motherhood. Maternal care is a conflictive exercise. On the one hand, it represents the status of being an adult and responsible but, on the other, it marks insecurity, lack of preparation and immaturity, which affect care to the newborn.Com o objetivo de analisar as representacoes sociais das adolescentes primiparas sobre o cuidado materno ao recem-nascido no âmbito domiciliar, realizou-se esse estudo qualitativo. Participaram oito adolescentes, com filhos primogenitos recem-nascidos. Os dados coletados em suas residencias, com tecnica projetiva e entrevistas semi-estruturadas, foram analisados a luz da teoria das representacoes sociais, evidenciando que as adolescentes representam o cuidado materno nos nucleos figurativos de afeicao, integracao familiar e realizacao materna. Simbolicamente, o cuidado materno ancora-se no surgimento da familia, na perenidade dos sentimentos e no compromisso com o desenvolvimento psicomotor da crianca. As primiparas adolescentes valorizam mais o ganho de pertencimento a uma familia do que as perdas acarretadas pela maternidade precoce. O cuidado materno e um exercicio conflitivo, ora representando o status de ser adulta e responsavel, ora denotando a inseguranca, o despreparo e a infantilidade, que afetam o atendimento ao recem-nascido.

Social and biological determinants of infant mortality in population cohort in the city of Passo Fundo, Rio Grande do Sul State

One investigated the social and biological determinants of infant mortality of a population cohort of 2,331 live births in the period February 2003 to January 2004, in the city of Passo Fundo, Rio Grande do Sul State, including 56 infant deaths. The databank of deaths had been increased to the databank of the birth cohort, which contained the social and biological variables obtained from live birth certificates and with home interviews. The coefficient of infant mortality of this cohort was 22.8%. Multivariate analyses with logistic regression and hierarchic model had shown that the following aspects were significantly associated with infant death: maternal educational level lower than eight years (RR= 5.7; IC 95%: 1.92-16.75), antecedent of dead children (RR= 3.7 (IC 95%: 1.07-12.10); low birth weight, with RR= 6.7 (IC 95%: 2.07-21.65) to 79.7 (IC 95%:14.36-441.92) for infants of low birth weight and weighing less than 1500g, respectively; Apgar scores < or =7 (RR=8.7; IC 95%: 2.85-26.32) and absence of breastfeeding (RR=15.75; IC 95%: 6.7663.68). As infant mortality in Passo Fundo is socially determined by the low maternal educational level and biologically determined by birth conditions, low birth weight and interruption of breastfeeding, one recommend the inclusion of these factors in the classification of risk for follow up of infant mortality in Passo Fundo.

Apoio social a gestantes adolescentes: desvelando percepções

This descriptive-exploratory study using a qualitative approach was undertaken to describe the perceptions of pregnant adolescents in relation to social support provided during pregnancy. Twelve adolescents in their first pregnancy who frequented the outpatient health service in Passo Fundo in the state of Rio Grande do Sul (Brazil) participated in the study. The data was obtained by semi-structured interviews, genograms and ecomaps and was assessed by thematic analysis. It highlighted the need for support to overcome the fears and challenges of motherhood. The mothers and partners were perceived as the main sources of support in affective and material terms. Common sense knowledge prevailed in the information dimension and pregnancy as a mediator in the reconciliation with the father fulfilled the emotional dimension. The perception of the dimension of positive social interaction was blurred by self-imposed isolation. Thus the adolescents perception of the social support received is clear in relation to the family nucleus and includes the people in the family circle. The network of care outside the family, including the healthcare services, is tenuous and generated the perception of psychosocial difficulties. This reveals the need for greater investment of primary healthcare professionals in the inclusion of first-time-pregnancy adolescents in social care groups, which ensure the healthy progress of the pregnancy.

Percepção materna quanto ao apoio social recebido no cuidado às crianças prematuras no domicílio

Este estudo qualitativo objetivou conhecer a percepcao das maes de criancas nascidas prematuras acerca do apoio social recebido no domicilio para o cuidado das mesmas. Incluiu 12 maes de prematuros, maiores de 20 anos, da area de cobertura das Unidades de Saude da Familia de Passo Fundo-RS. Os dados foram obtidos por meio de entrevista semi-estruturada, genograma e ecomapa. A analise evidenciou as avos como construtoras e mantenedoras do ninho social; desalento do abandono e base segura; e a inclusao social promovida pelos amigos. O apoio social nao suprido centrou-se no cuidado a crianca e nas atividades domesticas. A percepcao das maes revela um apoio predominantemente intra-familiar, cuja expansao permitiria configurar uma rede social mais efetiva para fortalecimento do cuidado materno.

Programas tutoriais para os cursos de enfermagem

A implementacao dos Projetos Politico-Pedagogicos, impulsionada pelas politicas de educacao e saude, gerou a necessidade de incorporar a matriz curricular varios programas para atender aos interesses e necessidades emanados dos cursos de graduacao. Um deles e o Programa Tutorial, destinado a amparar o aluno como sujeito da educacao e do cuidado. Nessa perspectiva, este estudo objetiva contribuir com a proposicao e avaliacao de um modelo tutorial, que possa preencher as lacunas detectadas no processo de construcao dos Projetos Politico-Pedagogicos. Para tanto, o artigo descreve o modelo teorico idealizado, com vistas a sua inclusao nos cursos de graduacao.The implementation of political-pedagogical projects, encouraged by health and education policies, generated the need to incorporate in nursing curricula several programs to attend the interests and necessities of undergraduate courses. One of these is the Tutorial Program that aims at considering the student as the subject of the education and care. In this way, this study aimed at contributing to the evaluation of a tutorial model in order to fill in gaps found in the process of construction of political-pedagogical projects. Therefore, the article describes the idealized theoretical model with the purpose to include it in undergraduate nursing programs.

Prevalência e fatores associados com o consumo de substâncias psicoativas por acadêmicos de enfermagem da Universidade de Passo Fundo

The objective of this epidemiologic transversal cut study was to investigate the consumption of psychoactive substances and their determinants between the nursery academics of the University of Passo Fundo, Rio Grande do Sul State. 266 students, aging more than eighteen years old answered a questionnaire of the Brazilian Center of Information about Psychoactive Drugs. A descriptive statistics, qui-square and multiple logistics regression were carried out for the data analysis. Of the sample, 94% had consumed alcohol in the life, 90% in that year and 79% in that month, 14% were characterized as heavy users. The girls had consumed benzodiazepines and stimulants more than the boys. The ones aging 20 year and more and females had evidenced minor possibility of alcohol consumption in the month and those with a monthly family income lower than ten salaries presented a greater possibility of marijuana (OR: 1.92), cocaine (OR:4.63) and inhalants (OR:7.02) consumption. The standard of psychoactive substance consumption is similar than the one found in other groups of colleges student, except for the benzodiazepines and stimulants, suggesting itself a deeper evaluation of this consumption.

A tutoria acadêmica no contexto histórico da educação

Trata-se de artigo de revisao com o objetivo de orientar a construcao de um modelo tutorial para cursos de graduacao. Dessa forma, busca resgatar a evolucao historica das tutorias na educacao desde a Antiguidade ate a atualidade, inserindo-as em diferentes modelos de universidade. A tutoria, concebida como responsabilidade do mestre pelo aluno ate torna-lo independente e capaz de ensinar outros alunos, surgiu junto com a universidade e, no transcurso dos seculos, foi valorizada como qualificadora do processo pedagogico. Na perspectiva atual, considera-se que a tutoria aglutina a formacao humanistica (cuidativa) e a tecnico-cientifica (educativa) numa dimensao hermeneutico-emancipatoria, compativel com a Pedagogia do Cuidado, orientadora de um modelo tutorial em construcao. It deals with a revision article aiming at guiding the building of a tutorial model for undergraduate courses. Thus, it seeks to ransom the historic evolution of tutoring since ancient times until nowadays, inserting itself into different models of the university. Tutoring, conceived as the responsibility of the teacher for the student until he/she is made independent and able to teach other students, has risen at the university and, along the centuries, has been valued as a qualifier of the pedagogical process. In the present perspective, one considers that tutoring also joins the humanistic (caring) shaping and technical-scientific (educational) shaping in a hermeneutic-emancipating dimension, which is compatible with the Care Pedagogy that guides the tutorial world under construction. Se trata de articulo de revision con el objetivo de orientar la construccion de un modelo tutorial para los cursos de grado. Asi, se busca rescatar la evolucion historica de las tutorias en la educacion desde la Antiguedad hasta la actualidad, insertandolas en diferentes modelos de universidad. La tutoria, concebida como responsabilidad del maestro frente al alumno hasta tornarlo independiente y capaz de ensenar a otros alumnos, surgio con la universidad y en el transcurso de los siglos fue valorada como calificadora del proceso pedagogico. En la actual perspectiva, se considera que la tutoria aglutina la formacion humanistica (cuidativa) y la tecnico-cientifica (educativa) en una dimension hermeneutico-emancipatoria, compatible con la Pedagogia del Cuidado, orientadora de un modelo tutorial en construccion.It deals with a revision article aiming at guiding the building of a tutorial model for undergraduate courses. Thus, it seeks to ransom the historic evolution of tutoring since ancient times until nowadays, inserting itself into different models of the university. Tutoring, conceived as the responsibility of the teacher for the student until he/she is made independent and able to teach other students, has risen at the university and, along the centuries, has been valued as a qualifier of the pedagogical process. In the present perspective, one considers that tutoring also joins the humanistic (caring) shaping and technical-scientific (educational) shaping in a hermeneutic-emancipating dimension, which is compatible with the Care Pedagogy that guides the tutorial world under construction.

Prevalência e determinantes maternos do consumo de medicamentos na gestação por classe de risco em mães de nascidos vivos

In order to identify the maternal determinants of the consumption of medication during pregnancy according to risk class, we conducted a population cohort baseline cross-sectional study with 2,262 mothers of liveborn infants in Passo Fundo, Rio Grande do Sul, Brazil. Data were collected from the Information System on Live Births and through home interviews (an instrument adapted from the Maternity Advice Survey). The drugs were classified according to criteria. We conducted bivariate analyses and logistic regression according to the hierarchical model of determination. 80% of the mothers consumed at least one medicine during the pregnancy, distributed in risk classes as follows: A (53.4%), B (18.1%), C (24.46%), D (1.47%), X (0.06%), and V (various) (2.1%). Incomplete prenatal care and maternal age < 20 years determined the consumption of medication in class A and pregnancy complications in classes B, C, and D. In class C, cesarean section and previous abortion also determined consumption, which in class V was independent of the variables analyzed. Maternal factors, especially health complications, determine the consumption of medicines during pregnancy, suggesting that the prescribing physician should orient the safe and proper use of such medication.