Ludmila Mourão Xavier Gomes

Quality of assistance provided to children with sickle cell disease by primary healthcare services

Objective To evaluate the quality of healthcare provided to sickle cell disease children by primary healthcare services in a region of high prevalence. Methods A cross-sectional, descriptive study was performed by interviewing members of families with sickle cell disease children. The children had been identified from the Neonatal Screening Program in Minas Gerais state over the last 12 years in towns of the Montes Claros-Bocaiuva microregion. A structured questionnaire specially developed for this study and based on three axes was used: indicators of the childs health (immunization, growth and development, prophylaxis antibiotic therapy), perception of care by the family (health education and accessibility) and knowledge of the family about the disease. Results Sixty-three of 71 families with children identified as having sickle cell disease were interviewed. The predominant genotypes were Hb SS (44.4%) and Hb SC (41.2%). Adequate monitoring of growth and development was recorded for the first year of life in 23 children (36.6%) and for the second year of life in 18 children (28.6%). The basic vaccination schedule was completed by 44 children (69.8%) but 62 vaccination record cards (98.4%) identified delays of special vaccines. Regular use of prophylactic penicillin was reported by 55 caregivers (87.3%). The familys perception of the care provided suggests poor accessibility to health services and lack of opportunities to answer doubts. The average performance of families in knowledge testing was 59.8%. Conclusion The quality of healthcare is unsatisfactory. The care provided to children with sickle cell disease in primary healthcare services needs improvements.

Mortalidade por causas externas em idosos em Minas Gerais, Brasil

Este es un estudio descriptivo con el objetivo de examinar la mor talidad por causas externas en los ancianos y el perfil de los obitos en este grupo de edad, en Minas Gerais, Brasil, desde 1999 hasta 2008. Los datos fueron obtenidos del Sistema de Informaciones sobre Mor talidad y del Departamento de Informatica del Ministerio de Salud. Los resultados mostraron aumento de los coeficientes de la mortalidad en ancianos durante los anos estudiados. Las caidas y accidentes de transporte se destacaron como las principales causas de muertes. Los resultados tambien mostraran crecientes tasas de homicidios y suicidios, especialmente en los ancianos varones. Medidas inmediatas de prevencion son necesarias, ya que los ancianos son cada vez mas sujetos a las muertes por causas externas.

Acesso e assistência à pessoa com anemia falciforme na Atenção Primária

Objective: To determine health community agents’ opinions on access and care delivery to individuals with sickle cell anemia. Methods: This was a qualitative study conducted among 14 health community agents from a municipality with a high prevalence of sickle cell disease. Data were submitted to analysis of thematic content. Results: Access to the basic health unit of individuals with sickle cell disease occurred only in situations of acute episodes. We observed a barrier between patients and basic health units. Care for patients with sickle cell disease was not prioritized for those with alert signs, nor was there specific follow-up in child rearing, vaccines, or medicines. Home visits were conducted without a systematic plan. Conclusion: According to the perspective of health community agents, the care of individuals with sickle cell disease was inadequate and individuals’ access to care was limited.

Understanding of technical education level professionals regarding sickle cell disease: a descriptive study

Objetivo: avaliar o conhecimento dos profissionais de nivel medio da Atencao Primaria a Saude sobre doenca falciforme na crianca.Metodo: estudo descritivo e transversal realizado com 357 agentes comunitarios de saude e tecnicos de enfermagem que responderam um questionario estruturado. O desempenho foi aferido atraves da media de acertos para os diferentes eixos do questionario.Resultados: o desempenho medio de acertos foi inferior a 65% em todos os dominios, sendo considerado critico para os eixos “manifestacoes clinicas” e “manejo da crianca com doenca falciforme”. Houve associacao estatistica entre melhor desempenho e as variaveis: funcao na equipe (OR=5,92; IC95%=1,90-20,49) e nivel de interacao com a doenca (OR=1,71; IC95%=1,09-2,69).Discussao: os profissionais devem estar preparados para atender a crianca com doenca falciforme.Conclusao: a falta de informacao dos profissionais nas acoes relativas ao manejo da crianca com doenca falciforme indica a necessidade de capacitacao dos profissionais para melhor qualidade da assistencia prestada.

Motivos que levaram as gestantes a não se vacinarem contra H1N1

As gravidas constituem um grupo de risco para qualquer infeccao devido a baixa imunidade que apresentam. Estudo descritivo com abordagem qualitativa, ancorada na Teoria das Representacoes Sociais que objetivou compreender os motivos que levaram as gestantes a nao se vacinarem contra a Influenza A (H1N1). Participaram do estudo 10 mulheres que estavam gravidas no periodo da campanha de vacinacao de 2010. Os dados foram coletados em maio de 2011 mediante entrevistas semiestruturadas e discutidas pela analise de conteudo. A partir dos discursos foi possivel identificar as varias representacoes que a vacina H1N1 tinha para essas mulheres no periodo de sua gestacao, como elemento que causaria aborto e ma formacao do feto. Os motivos que levaram as gestantes a nao se vacinarem contra a gripe H1N1 estao associados ao medo, a falta de informacao e aos mitos e crencas que a populacao traz nas suas representacoes e nos seus valores culturais.

Reasons why pregnant women did not vaccinate against Influenza A H1N1

Pregnant women constitute a risk group for any infection due to their low immunity condition. This is a descriptive study with a qualitative approach, grounded in the Theory of Social Representations that sought to understand the reasons why pregnant women did not vaccinate against influenza A (H1N1). The study included 10 women who were pregnant during the vaccination campaign of 2010. Data were collected in May 2011 through interviews and interpreted by content analysis. From the speeches it was possible to identify the various representations that the vaccine against H1N1 had for these women during their pregnancy as an element which would cause miscarriage and birth defects. The reasons why pregnant women did not vaccinate against H1N1 are associated with fear, lack of information and the myths and beliefs that people bring in their representations and their cultural values.

Expectativas e percepções dos estudantes do curso técnico em enfermagem com relação ao mercado de trabalho

The objective of this study with its qualitative and descriptive approach was to identify the perceptions and expectations nursing technician school students with respect to the labor market. The data was collected in October of 2009 using semi-structured interviews among 12 nursing technician students. The data was submitted to content analysis, which demonstrated that the interviews revealed important issues related to nursing employability among the categories, the areas of professional activity, and the integration of nursing technicians within the health care team. These results show the need for further discussion within the theme, seeking to increase and improve nursing technician formal education for the needs of the labor market. It beheld the existence of negative factors such as discrimination and limited social recognition. In conclusion, the future student seeks, beyond employment, his/her insertion in society for appreciation as a health care professional. DESCRIPTORS: Students. Job market. Nursing. Education, nursing. Education, nursing, associate.

Effectiveness of an educational programme about sickle cell disease in the form of active methodologies among community health agents and nursing technicians of primary care in Minas Gerais, Brazil.

Background: The incidence of sickle cell disease (SCD) in newborns in Minas Gerais, Brazil is 1:1400, and is a considerable public health problem. Care for SCD at the primary level is still in its early stages and has not even been assessed even worldwide. Aim: To evaluate the effectiveness of a training programme about childhood SCD aimed at primary care professionals. Methods: Assessment of a SCD training course for 263 community health agents of the Family Health Programme was conducted using pre- and post-testing of knowledge related to epidemiological and clinical issues and management of children with SCD. In one of the three municipalities evaluated, the group that participated in the training (n = 82) was compared with a control group (n = 75). Active methods that consider trainees as the key protagonists of the educational programme were used throughout. The control group did not receive any training on SCD during the period. Results: There was a significant increase in correct answers to questions after the intervention in the three municipalities (P < 0.001). This increase was significant in all the domains of the questionnaire. In a multivariate analysis, professionals in the intervention group showed a post- and pre-test score difference that was 8.7 times higher than that in the control group (95% CI 7.8–9.6). The length of employment as a community health worker had a modest positive effect on the difference in scores (P = 0.046). Conclusion: The educational intervention proved effective in increasing health care providers’ knowledge.

Repercussões maternas e fetais da analgesia obstétrica: uma revisão integrativa

•1• Enfermeiro, Faculdades Santo Agos -tinho. Montes Claros, Brasil. E-mail: hudson.amaral@hotmail.com•4• Mestre em Ciencias da Saude. Montes Claros, Brasil.•5• Doutora em Ciencias da Saude. Foz do Iguacu, Brasil.•2• Enfermeiro, Faculdades Santo Agos-tinho. Montes Claros, Brasil. E-mail: bran-cobillymoccity@htomail.com•3• Enfermeira, Especialista em Obstetricia. Docente, Faculdades Santo Agostinho. Montes Claros, Brasil.

Perception of primary care doctors and nurses about care provided to sickle cell disease patients

Objective To analyze the perception of primary care physicians and nurses about access to services and routine health care provided to sickle cell disease patients. Methods This descriptive exploratory study took a qualitative approach by surveying thirteen primary care health professionals who participated in a focus group to discuss access to services and assistance provided to sickle cell disease patients. The data were submitted to thematic content analysis. Results Access to primary care services and routine care for sickle cell disease patients were the categories that emerged from the analysis. Interaction between people with sickle cell disease and primary care health clinics was found to be minimal and limited mainly to scheduling appointments. Patients sought care from the primary care health clinics only in some situations, such as for pain episodes and vaccinations. The professionals noted that patients do not recognize primary care as the gateway to the system, and reported that they feel unprepared to assist sickle cell disease patients. Conclusion In the perception of these professionals, there are restrictions to accessing primary care health clinics and the primary care assistance for sickle cell disease patients is affected.