Maria Amanda Correia Lima

Vaccination status of people living with HIV/AIDS in outpatient care in Fortaleza, Ceará, Brazil

Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA). The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria. Data were collected for interviews using forms to characterize sociodemographic, clinical and vaccination situations. Only 14 patients had complete vaccination schedules. The most used vaccines were hepatitis B, influenza vaccine and 23-valent pneumococcal. There was no difference between men and women regarding the proportion of PLWHA with full vaccination schedule or between sex, skin color, marital status, sexual orientation, religion or occupational status. There was no difference between having or not having a complete vaccination schedule and age, years of education, family income or number of hospitalizations. CD4+ T-cells count of patients with incomplete immunization was lower than patients with complete immunization. Health education strategies can be done individually or in groups to explain the importance of vaccination and to remind about doses to be administered. Most patients did not have proper adherence to vaccination schedules, especially due to lack of guidance. Results implied that education in health is important for vaccination adhesion, knowledge of adverse events and continuation of schemes.

Resíduos de insulinoterapia produzidos no domicílio de diabéticos acompanhados na Atenção Primária

Objective To analyze the insulin therapy waste disposal produced in the households of people with diabetes mellitus (DM). Method Cross-sectional study with 105 Primary Care patients. Socio-demographic and clinical variables and insulin therapy practice were analyzed through the absolute and relative frequencies, Fishers exact test and prevalence ratio (PR). Results The association between types of insulin (60.0%), administered with a disposable syringe attached to a needle (80.9%), and a high percentage of reuse and disposal in normal household waste (57.1%) stood out. The professionals who most frequently provided guidance to people with diabetes were the nurses. Patients who had received instructions about disposal were 21 times more likely to dispose of waste properly than those who had not (PR 21.5; P < 0.0001). Age, gender, skin color, education, marital status, occupational status and type of DM did not interfere in the disposal (P > 0.05). Conclusion People with diabetes served in Primary Health Care require guidance and material resources to carry out the appropriate disposal of insulin therapy waste.

Effect of Social Support on Quality of Life, CD4+ T-cell Count and Viral Load of People Living With HIV/AIDS

Background: Social support is an information leading the subject to believe that is cared, esteemed, and is member of a network of mutual obligations. Studies showed that absence of social support could increase vulnerability to diseases. The purpose of study was to analyze the effect of social support on quality of life (QOL), CD4+ T-cell count and viral load of people living with HIV/AIDS (PLWHA) in ambulatorial service. Method: This cohort study was a one-year follow-up with first evaluation between August 2012 and August 2013, the second evaluation between August 2013 and August 2014. The sample was 201 subjects, divided in exposed cohort (N=134), with satisfactory social support, and in not exposed cohort (N=67), with unsatisfactory social support. Data were collected through interviews using instruments: sociodemographic and clinical form, social support scale, and an instrument for assessing quality of life (WHOQOL-HIV-Bref). Findings: PLWHA with satisfactory social support no have changes in mean scores of perception of QOL to overall quality of life/general health perception, and in relation to the physical, psychological, social relationships domains, through environment and spirituality/religion/beliefs. There was difference in level of independence domain (P=0.022), which showed an increase in mean scores related to perceptions of QOL. In the analysis of CD4+ T-cell count and viral load there was no statistically significant difference to PLWHA with unsatisfactory social support. Conclusions: PLWHA with satisfactory social support had increased mean scores for the level of independence domain, decreased CD4+ T-cell counts and viral loads.

Prevalence of arterial hypertension and risk factors among people with acquired immunodeficiency syndrome

* Artículo parte de la disertación de maestría “Prevalencia de hipertensión arterial y sus factores de riesgo entre personas con vih/sida en uso de terapia antirretroviral”, presentada en la Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brasil. 1 Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brasil. 2 Universidade Federal do Ceará, Centro de Pesquisa e Desenvolvimento de Medicamentos, Fortaleza, CE, Brasil. Prevalencia de hipertensión arterial y factores de riesgo entre personas con síndrome de inmunodeficiencia adquirida*ABSTRACT Objectives: to verify the prevalence of arterial hypertension and its risk factors among people with acquired immunodeficiency syndrome under antiretroviral therapy. Method: cross-sectional study with 208 patients. Data collection was conducted through interviews using a form containing data on sociodemographic, clinical and epidemiological aspects, hypertension risk factors, blood pressure, weight, height, body mass index and abdominal circumference. Mean, standard deviation, odds ratio and confidence interval were calculated, t-test and Chi-square test were used, considering P < 0.05 as statistically significant. Hypertension associated variables were selected for logistic regression. Results: patients were male (70.7%), self-reported as mixed-race (68.2%), had schooling between 9 and 12 years of study (46.6%), had no children (47.6%), were single (44.2%), in the sexual exposure category (72.1%) and heterosexual (60.6%). The prevalence of people with acquired immunodeficiency syndrome and arterial hypertension was 17.3%. Logistic regression confirmed the influence of age greater than 45 years, family history of hypertension, being overweight and antiretroviral therapy for more than 36 months for hypertension to occur. Conclusion: the prevalence of hypertension was 17.3%. Patients with acquired immunodeficiency syndrome and hypertension were older than 45 years, had family history of hypertension, were overweight and under antiretroviral therapy for more than 36 months.

Diagnósticos de enfermería según la teoría del autocuidado en pacientes con infarto de miocardio

Objective: Identify nursing diagnoses in patients with myocardial infarction in hospital emergency situations, according to Orem´s self-care theory. Materials and methods: This is a cross-sectional study that was conducted from February to August 2016 with 50 infarcted patients who were able to participate in the research. Data collection was done through an interview, using a questionnaire pursuant to the self-care theory, and the nursing diagnoses were formulated based on the NANDA-I Taxonomy. Results: The majority of patients were women (54%) ages 60 to 69 (34%), with family incomes ranging from one to two minimum wages (88%), with basic education (70%) and retirees (76%). There was a high frequency of arterial hypertension (62%), physical inactivity (76%) and smoking (70%). The rapid test for troponin was positive in 16 of the participants (32%). Many of the infarcted patients had self-care deficits that were indicated in 10 nursing diagnoses, particularly sedentary lifestyles (80%), physically impaired mobility (76%), and risk of activity intolerance (76%). Risk-prone health behavior and self-neglect were related to three self-care requirements. Conclusion: The patients needed health assistance for changes in lifestyle, comfort measures, and the realization of activity and rest.