Lúcia Yasuko Izumi Nichiata

Conversando sobre sexo: a rede sociofamiliar como base de promoção da saúde sexual e reprodutiva de adolescentes

This study aimed to assess whom adolescents shared information and dialogues about sexuality with. Therefore, 383 fifteen to nineteen year-old adolescents enrolled in a family health unit in the city of Sao Paulo (Brazil) were interviewed in 2002. Adolescents most frequently seemed to talk about sex with peers, although they lost priority according to the complexity of the theme. Thus, teachers and health professionals were mainly indicated as a reference when talking about std/aids. For 20% of the adolescents, parents were the main persons to get information from, no matter the subject. The results indicated that this entire social and family network should be incorporated as partners in sexual and reproductive health promotion among adolescents.This study aimed to assess whom adolescents shared information and dialogues about sexuality with. Therefore, 383 fifteen to nineteen year-old adolescents enrolled in a family health unit in the city of São Paulo (Brazil) were interviewed in 2002. Adolescents most frequently seemed to talk about sex with peers, although they lost priority according to the complexity of the theme. Thus, teachers and health professionals were mainly indicated as a reference when talking about std/aids. For 20% of the adolescents, parents were the main persons to get information from, no matter the subject. The results indicated that this entire social and family network should be incorporated as partners in sexual and reproductive health promotion among adolescents.

The use of the "vulnerability" concept in the nursing area

2 Este artigo teve por objetivo realizar breve resgate do conceito de vulnerabilidade que vem sendo utilizado na area da saude e discutir sua utilizacao pela enfermagem. Os estudos, em meio a diversidade de enfoques e objetos, tem buscado superar o raciocinio classico de risco em epidemiologia, avancando para a discussao dos determinantes sociais na producao dos agravos.The objective of this article was to briefly retrieve the meaning of the vulnerability concept, which has been used in the healthcare area; also, to discuss how it has been used in the Nursing area. Amidst several different focuses and objects, studies have been attempting to overcome the classical reasoning of risk in epidemiology, advancing towards the discussion of the social determinants for the production of health problems.

Os conceitos de vulnerabilidade e adesão na Saúde Coletiva

Los conceptos de Vulnerabilidad y Adhesion han sido foco de debate en la Salud Colectiva. El desafio puesto por este campo, de propiciar tecnologias, dispositivos e instrumentos que apoyen la construccion de practicas calificadas, para atender a las necesidades de los grupos sociales, ha constituido el terreno donde se elabora el conocimiento, buscando la innovacion en el desarrollo de instrumentos que apoyen la captacion de la realidad, apoyen la lectura de las necesidades y en el desencadenamiento y sustentacion de proyectos de intervencion que produzcan el impacto deseado: atender los grupos sociales que mas carecen de apoyo para conquistar autonomia para vivir la vida con calidad y la consecucion del auto-cuidado, en el escenario de la equidad y de la justicia social. El articulo presenta aspectos de las categorias analiticas Adhesion y Vulnerabilidad, en cuanto a la proposicion de indicadores para su monitoreo, lo que puede contribuir para el desarrollo del concepto y para las practicas en el proceso de produccion a la salud.The Vulnerability and the Compliance are concepts that have being focus of debate in the Collective Health field. The challenge of the Collective Health is to promote tech- nologies, and tools to support qualified actions, and to answer to the social groups´ needs, looking for the innovation of the in- struments to apprehend the reality and to develop interventions that could produce impacts: attending these social groups who needs support to conquer autonomy in the self-care. This article presents aspects of the analytic categories Compliance and Vulnerability, proposing indicators for monitoring it, in order to contribute to the development of the concepts as to the health production process.

Biossegurança em DST/AIDS: condicionantes da adesão do trabalhador de enfermagem às precauções

Visando identificar os condicionantes da adesao do trabalhador de enfermagem as precaucoes/isolamento na assistencia, realizou-se este estudo do tipo descritivo tendo como populacao alvo enfermeiros representantes de hospitais de medio e grande portes da cidade de Sao Paulo. Das 79 instituicoes que se enquadravam nos criterios determinados, 15 (18,98%) constituiram a amostra. Em reuniao coletiva, utilizou-se a tecnica de grupo focal para a coleta dos dados sendo as discussoes gravadas em fita cassete, mediante consentimento dos participantes e, posteriormente, transcritas. Organizaram-se os dados segundo Bardin (1977), extrairam-se os nucleos tematicos e definiram-se duas categorias de analise empiricas, denominadas condicionantes institucionais e individuais.Teniendo como objetivo identificar los factores que condicionan la adhesion del trabajador de enfermeria a las medidas de precaucion/aislamiento en la atencion de enfermeria, se realizo este estudio descriptivo que tuvo como blanco a enfermeros representantes de hospitales de mediano y gran tamano de la ciudad de Sao Paulo. De las 79 instituciones que se encuadraban en los criterios determinados, 15 de ellas (el 18,98%) constituyeron la muestra. En una reunion colectiva, se recopilaron los datos utilizandose la tecnica del grupo focal, las discusiones fueron grabadas en una cinta casset, con el consentimento de los participantes y, posteriormente fueron transcriptas. Los datos se organizaron segun Bardin (1977) y se extrajeron los nucleos tematicos definiendose dos categorias de analisis empiricos, denominadas condicionantes institucionales e individuales.

A utilização do conceito "vulnerabilidade" pela enfermagem

2 Este artigo teve por objetivo realizar breve resgate do conceito de vulnerabilidade que vem sendo utilizado na area da saude e discutir sua utilizacao pela enfermagem. Os estudos, em meio a diversidade de enfoques e objetos, tem buscado superar o raciocinio classico de risco em epidemiologia, avancando para a discussao dos determinantes sociais na producao dos agravos.The objective of this article was to briefly retrieve the meaning of the vulnerability concept, which has been used in the healthcare area; also, to discuss how it has been used in the Nursing area. Amidst several different focuses and objects, studies have been attempting to overcome the classical reasoning of risk in epidemiology, advancing towards the discussion of the social determinants for the production of health problems.

Evolução dos isolamentos em doenças transmissíveis: os saberes na prática contemporânea

The identification of new infectious agents and the ever increasing expansion of known infections and diseases have been stimulating the revision of biosafety measures in the activities of professional health care workers. In the present article, the evolution of knowledge and practices of isolation and precautions were reviewed, which allowed us to recover the concepts and the interventions that were formulated and implemented. Since the beginning of the modern nursing, in the XIX century, the elements of the isolation practice for contagious diseases have remained basically the same. In other words, the emphasis on the use of mechanical, chemical and environmental barriers are given, based on inherent specificities of each part of the infectious chain process.The identification of new infectious agents and the ever increasing expansion of known infections and diseases have been stimulating the revision of biosafety measures in the activities of professional health care workers. In the present article, the evolution of knowledge and practices of isolation and precautions were reviewed, which allowed us to recover the concepts and the interventions that were formulated and implemented. Since the beginning of the modern nursing, in the XIX century, the elements of the isolation practice for contagious diseases have remained basically the same. In other words, the emphasis on the use of mechanical, chemical and environmental barriers are given, based on inherent specificities of each part of the infectious chain process.

A sociedade civil contra a Aids: demandas coletivas e políticas públicas

This article features a discussion about the bibliographical output on the organization of civil society in the campaign against Aids in Brazil. The objective was to analyze the different forms of articulation of the social players in accordance with the manifestation of collective needs and the achievement of public policies. The literature in the area of health and social sciences was reviewed from the outbreak of the Aids epidemic in Brazil through to the present moment. The results show that the pressure applied by mobilized groups at the beginning of the epidemic produced a response of the public authorities for whom the benchmark was right to access and comprehensive care of people infected with HIV/Aids. Currently, there are heterogeneous groups of organized civil society working on enhancing existing public policies and consolidating achievements in the area. The importance of this study lies in the need to strengthen collective action to demand answers from the public authorities in order to tackle the new needs of the campaign to fight Aids.

Mulheres vivendo com aids e os profissionais do Programa Saúde da Família: revelando o diagnóstico

This qualitative study was carried out with women living with HIV/AIDS cared by a specialized STD/AIDS service and registered in a Family Health Program (FHP) unit. The purpose was to identify the motivations of women living with HIV/AIDS to provide private information to the FHP team. The study was performed using semi-structured interviews, analyzed with the bioethics theoretical framework. It was verified that women disclose the diagnosis to the FHP team when: the HIV/AIDS diagnosis was made in the unit; they feel there is better treatment for being HIV positive; they are bond as family members; there is trust; and women feel that they do not feel pity of them. Women so not disclose when: the professionals attitude produces fear and unreliability; they think that the FHP takes care of bedridden patients; they do not trust by fearing secret disclosure; and they already have all the care needed in the SCS.Trata-se de um estudo qualitativo realizado com mulheres infectadas pelo HIV/aids atendidas por um servico especializado em DST/aids e matriculadas por uma equipe do Programa Saude da Familia. Teve como objetivo identificar quais as motivacoes para abrir a privacidade de suas informacoes para a equipe de PSF das mulheres soropositivas ao HIV/aids. Foi realizado por meio de entrevistas semi-estruturadas, analisadas com o referencial teorico da bioetica. Verificou-se que as mulheres revelam o diagnostico a equipe de PSF quando: o diagnostico de soropositividade foi feito na unidade; sentem que sao melhor atendidas por serem soropositivas ao HIV; tem vinculo como se fossem familiares; confiam; e sentem que nao sentem pena. E nao revelam quando: a atitude do profissional gerou medo e inseguranca; acham que o PSF cuida de pessoas acamadas; nao confiam por medo de quebra do sigilo; e ja possuem toda assistencia que precisam no SAE.

Conhecimento, atitude e práticas na prevenção do câncer de colo uterino e hpv em adolescentes

Resumen La iniciación sexual cada vez más temprana propicia un nivel alto de vulnerabilidad de los adolescentes a los problemas de la esfera sexual / reproductiva, incluyendo el cáncer del cuello del útero y la infección por VPH. Este estudio tuvo como objetivo identificar los conocimientos, actitudes y prácticas en la prevención de cáncer cervical y la infección por VPH en la población adolescente y evaluar las situaciones que los tornan vulnerables. Este es un estudio transversal realizado en una escuela pública en Sao Paulo con 134 adolescentes entre 14 y 19 años. El promedio de la edad de iniciación sexual fue de 14,8 años. La mayoría de los adolescentes no tienen conocimientos adecuados sobre la prevención de este tipo de cáncer. También presentó bajas tasas de la prueba del Papanicolaou . Las estadísticas justifican la inclusión de estas adolescentes en los programas para la detección de este cáncer. Es indispensable invertir en la educación sexual en las instituciones educativas aunadas con campañas sobre la impor tancia del Papanicolaou vinculadas con actividades educativas que tengan un enfoque adecuado y un lenguaje apropiado. Palabras clave: Adolescente. Enfermedades de Transmisión Sexual. Frotis Vaginal. Neoplasias del Cuello Uterino. 1Enfermeira. Especialista em Saúde Pública. Mestranda em Enfermagem em Saúde Coletiva pela USP. Brasil. E-mail: ferla@usp.br, 2Enfermeira. Doutora em Enfermagem em Saúde Coletiva pela USP. Professora do Depar tamento de Enfermagem em Saúde Coletiva da USP. Brasil. E-mail: izumi@usp.br, 3Enfermeira. Doutora em Enfermagem em Saúde Coletiva pela USP. Professora do Depar tamento de Enfermagem em Saúde Coletiva da USP. Brasil. E-mail: analuizavb@gmail.com PESQUISA RESEARCH INVESTIGACIÓN Sexual initiation increasingly early offers high vulnerability of adolescent to problems in the sexual/reproductive scenario, including cancer of the uterine cervix and HPV infection. This study aimed to identify the knowledge, attitude and practice in the prevention of cervical cancer and HPV infection in adolescent populations and assess the situations that make them vulnerable. The cross-sectional study was conducted in a public school in Sao Paulo with 134 adolescents between 14 and 19 years old. The age of sexual initiation is 14.8 years on average. Most adolescents had no adequate knowledge about the prevention of this malignancy. The access to Papanicolaou test was also low in this population. Statistics justify the inclusion of adolescents in programs for detection of cancer. We must invest in sex education in educational institutions and join the campaign for collecting Papanicolaou with educational activities with appropriate focus and language appropriate to change the current scenario. keywords: Adolescent. Sexually Transmitted Diseases. Vaginal Smears. Uterine Cervical Neoplasms. Ferla Maria Simas Bastos Cirino1 Knowledge, attitude and practice in the prevention of cervical cancer and HPV in adolescents Ana Luiza Vilela Borges3

The potential of an instrument to identify social vulnerabilities and health needs: collective health knowledge and practices.

Este estudio tuvo como objetivos analizar un instrumento de lectura del proceso salud enfermedad y evaluarsu potencial para el reconocimiento de vulnerabilidades sociales y necesidades de salud, posibilitandointervenciones mas adecuadas en un dado territorio. Los procedimientos usados se constituyeron de analisisdel instrumento de recoleccion de datos – compuesto por preguntas cerradas y abiertas para el reconocimientode los diferentes perfiles de reproduccion social (formas de trabajar y de vivir) – utilizado en el Proyecto deDesarrollo Pedagogico y de informes de las actividades desarrolladas por alumnos del Departamento deEnfermeria en Salud Colectiva de la Escuela de Enfermeria de la Universidad de San Pablo(USP). Se concluyeque el instrumento analizado posibilita a los profesionales de la salud, particularmente de Enfermeria en SaludColectiva, reconocer vulnerabilidades sociales y necesidades de salud, orientando sus intervenciones en diferentescontextos, segun la perspectiva de la promocion de la salud. Revela, asi, un potencial transformador de laspracticas de salud vigentes, caracter dinamico y de renovacion constante de esas practicas en diferentescontextos, segun la “radicalidad” propia de la Salud Colectiva.DESCRIPTORES: evaluacion de necesidades; vulnerabilidad social; enfermeria; salud publica; prestacion deatencion de salud; educacion