Luciana Saraiva da Silva

Construção de portfólios coletivos em currículos tradicionais: uma proposta inovadora de ensino-aprendizagem

Education to promote health has traditionally been based on knowledge transmission methodologies. However, the current scenario calls for the training of professionals with a critical-reflective profile, who are able to work in teams. We present the report of an innovative experience using the construction of collective portfolios as instruments of learning, changing attitudes and training of undergraduates, in a traditional subject-based curriculum structure context. It is a descriptive exploratory study, with a qualitative-quantitative approach, based on analysis of collective portfolios (n=9), built by Health Policy students, together with an open questionnaire to students who attended the course (n=58) and also the staging of focus groups (n=3). The use of collective portfolios mobilized students in critical and reflective thinking on Brazilian health policy - the Unified Health System - broadening the concept on the health-disease process and practices related to health services, prioritizing teamwork and the active search for knowledge building, stressing the exercise of otherness, resilience and empowerment.

A problemática da adesão na prevenção da anemia ferropriva e suplementação com sais de ferro no município de Viçosa (MG)

The scope of this article is to analyze the understanding of mothers and persons responsible for infants taking ferrous sulfate supplement about anemia and its consequences, assessed by the level of adherence to supplementation. A prospective, qualitative and quantitative population study was conducted with non-anemic children not taking supplements to receive prophylactic supplementation with ferrous sulfate for six months. After six months, there was adherence to supplementation. Among the 133 children initially eligible for the study, 97 returned for the second evaluation. Of these, 4 had anemia during the follow-up and began treatment and 3 others were brought in by individuals who were unable to provide information on use of the supplement. High adherence was showed by 56.7% of children and low adherence by 43.3%, while 23.3% had interrupted supplementation due to the lack of guidance and support of the health service. Mothers and persons responsible of the two groups (high and low adherence) manifested little knowledge about anemia, its prevention and health consequences for the child. More information regarding iron deficiency anemia, routine follow-up by professionals and evaluation of the perception of individuals involved with iron supplementation is necessary.

Análise de três estratégias de educação em saúde para portadores de hipertensão arterial

The scope of this article is to compare the effect of three health and nutrition education strategies on adherence to the non-pharmacological treatment of systemic arterial hypertension (SAH), using anthropometric, biochemical, clinical and dietetic parameters. It is a longitudinal intervention study of the comparative and quantitative approach community test. The sample was comprised of 212 individuals diagnosed with SAH, who met the inclusion/exclusion criteria. Participants were allocated into three groups, in order to evaluate different methods of intervention, carried out on a monthly basis, for twelve months. The Kolmogorov-Smirnov, ANOVA and Kruskal-Wallis tests were performed for the analyses. Educational interventions in Group 1 and 2 provided the best results on adherence to the non-pharmacological treatment of SAH. In the comparative analysis of different groups, the reduction of glucose showed statistical significant difference, with Group 2 showing the best evolution. Group 1 and 2 had better results on adherence to non-pharmacological treatment of SAH. It is important to stress that in health service practices there is a challenge to promote health education able to intervene on the issue of adherence to the treatment of SAH.The scope of this article is to compare the effect of three health and nutrition education strategies on adherence to the non-pharmacological treatment of systemic arterial hypertension (SAH), using anthropometric, biochemical, clinical and dietetic parameters. It is a longitudinal intervention study of the comparative and quantitative approach community test. The sample was comprised of 212 individuals diagnosed with SAH, who met the inclusion/exclusion criteria. Participants were allocated into three groups, in order to evaluate different methods of intervention, carried out on a monthly basis, for twelve months. The Kolmogorov-Smirnov, ANOVA and Kruskal-Wallis tests were performed for the analyses. Educational interventions in Group 1 and 2 provided the best results on adherence to the non-pharmacological treatment of SAH. In the comparative analysis of different groups, the reduction of glucose showed statistical significant difference, with Group 2 showing the best evolution. Group 1 and 2 had better results on adherence to non-pharmacological treatment of SAH. It is important to stress that in health service practices there is a challenge to promote health education able to intervene on the issue of adherence to the treatment of SAH.

Adherence to non-pharmacological treatment: Analysis of the impact of three health educational and nutritional strategies in hypertensive patients

Objective: To evaluate adherence to non-pharmacological treatment of hypertension by comparing biochemical, clinical, anthropometric, and dietary parameters before and after three health educational and nutritional strategies. Methods: This longitudinal clinical trial included 212 hypertensive individuals who met the inclusion criteria. The participants were allocated to three groups to assess the impact of monthly intervention methods over twelve months. Results: Waist circumference decreased significantly in all groups. Weight and body mass index decreased significantly in Groups 2 and 3. Blood glucose, total cholesterol, and low-density lipoprotein cholesterol decreased significantly in Groups 1 and 2. The interventions also reduced the mean per capita intakes of oil, sugar, and salt in all groups. Conclusion: Educational interventions promoted adherence to non-pharmacological treatment of treatment of hypertension evidenced by anthropometric (weight, body mass index, and waist circumference), biochemical (blood glucose, total cholesterol, and low-density lipoprotein cholesterol), and dietary (meanper capita intake of oil, sugar, and salt) parameters.

Influência de intervenções educativas em perfis antropométricos, clínicos e bioquímicos e na percepção de saúde e doença de portadores de hipertensão arterial no contexto da Saúde da Família

Objective: To analyze the influence of educational interventions on the anthropometric, clinical, and biochemical profiles and perceived health and disease of individuals with high blood pressure in the context of the Family Health Strategy. Methods: This longitudinal, interventional, and comparative study included individuals with high blood pressure registered at and followed by the Family Health Strategy of the municipality of Porto Firme, Minas Gerais, Brazil. Twelve-month educational interventions were conducted in the Family Health Strategy facilities and during home visits. Socioeconomic characteristics, life habits, health care data, understanding and knowledge about high blood pressure, perceived health and disease, and anthropometric, biochemical, and clinical variables were analyzed before and after the interventions. Results: The clinical, biochemical, and anthropometric variables improved, albeit by not much. The interventions changed body mass index (0.001), waist circumference (p<0.001), blood glucose (p=0.011), total cholesterol (p<0.001), high-density lipoproteins cholesterol (p<0.001), and triglycerides (p=0.019) significantly. The interviewees demonstrated that they had incorporated new knowledge on the meaning of high blood pressure, and their perceived health and disease was more strongly related to subjective aspects of their life experience and quality of life than to biological and medical issues. Conclusion: The educational interventions proved to have a high potential to fight high blood pressure by promoting positive changes on the study profiles. However, their effect is strongly related to their continuous provision.

Assessment of different detection methods of chronic kidney disease and their importance for an early diagnosis

AimThe prevalence of chronic kidney disease (CKD) has been increasing worldwide. In practice, the glomerular filtration rate (GFR) can be assessed by the dosage of creatinine serum, its clearance through the kidneys and estimation formulae. However, there is no existing consensus about the best method of assessment; therefore, the aim of the present study is to assess the different methods of detecting CKD.Subjects and methodsA total of 293 hypertensive patients participated in the research. Creatinine serum and clearance were assessed to analyze kidney function. The GFR was estimated using the following formulae: Cockcroft and Gault (CG); CG-corrected; Modification of Diet in Renal Disease (MDRD)-6; MDRD-4 and The Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI). The following tests were used: weighted Kappa coefficient; Pearson’s correlation (r) and Bland-Altman graph analysis.ResultsThe greatest agreement found using the weighted Kappa was for the CKD-EPI formula (k = 0.362). The greatest correlation was found for the CKD-EPI formula (r = 0.612). The CKD-EPI formula exhibited the lowest number of individuals below the lowest limit of agreement in the Bland-Altman analysis.ConclusionsThe CKD-EPI formula should be used to estimate the GFR, given that it exhibited the greatest correlation and agreement with creatinine clearance; thus, it is possible to implement low-cost activities focusing on early detection and diagnosis, as well as the prevention of CKD.

A problemática da adesão ao tratamento da hipertensão no contexto da Saúde da Família

Systemic arterial hypertension (SAH) is a serious public health problem in the world. Changes in lifestyle are considered fundamental in the prevention and control of hypertension, which can be achieved through health education actions at the level of primary care. The aim of this study was to evaluate the effect of two strategies of nutrition and health education for the orientation of dietary changes indicated in the treatment of SAH. The study was conducted with women having hypertension (n = 27) in the city of Porto Firme-MG. The intervention consisted in: 1) educational group activities (G1, n = 14); 2) educational group activities and household guidelines (G2, n = 13). The study evaluated the evolution of anthropometric, biochemical, clinical and dietetic parameters in three stages: T1 before the intervention, T2 – at the end of the intervention and T3 eight months after interventions stopped. In group 1, there was no statistically significant differences in the parameters, while in group 2 there was statistically significant differences for the values of waist circumference (p = 0,030), systolic blood pressure (p = 0,012) and consumption of salt (p = 0,003). While they were instructed, the women followed the dietary guidelines which positively influenced the parameters from T1 to T2. In T3, it was observed that the changes were not incorporated in their lifestyle.