Maria Angelina Nardi de Souza Martinez

Proposta para capacitação de agentes comunitários de saúde em saúde auditiv

TEMA: capacitacao de agentes comunitarios de saude na area de saude auditiva. OBJETIVO: verificar a efetividade de um programa de capacitacao de agentes comunitarios de saude do Programa de Saude da Familia, na area de saude auditiva infantil. METODO: a casuistica constou de dois grupos: grupo A foi constituido por 31 agentes comunitarios de saude da cidade de Bauru e, grupo B, formado por 75 agentes comunitarios de saude de Sorocaba, ambos municipios do Estado de Sao Paulo. A capacitacao foi realizada por meio de aulas expositivas para os dois grupos, contudo para o grupo A foi utilizado uma apostila adaptada da World Health Organization (2006), para que os agentes comunitarios de saude pudessem acompanhar as atividades realizadas de forma interativa. A capacitacao abordou os temas: audicao e deficiencia auditiva, tipos, prevencao e causas da deficiencia auditiva, tecnicas de identificacao e diagnostico da deficiencia auditiva e aspectos gerais da deficiencia auditiva. Para validar a capacitacao foi aplicado um questionario pre e pos-capacitacao com perguntas sobre os assuntos que foram abordados no decorrer do curso, a fim de analisar a assimilacao do conteudo ministrado. RESULTADOS: a capacitacao foi efetiva, com aumento no escore total obtido nos questionarios pre e pos-capacitacao. CONCLUSOES: os resultados comprovam a eficacia do programa de capacitacao com utilizacao de material e abordagem interativa proposto para os agentes comunitarios de saude dos Programas de Saude da Familia.

Análise crítica de três protocolos de triagem auditiva neonatal

BACKGROUND: having knowledge about the validity of procedures for newborn hearing screening (NHS) is fundamental, once the purpose of these programs is to identify all newborns with hearing loss at an acceptable cost. AIM: to estimate the specificity and the false-positive rate of NHS protocols using transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR). METHOD: participants were 200 newborns who were submitted to a hearing screening test between March and July 2006. Three protocols were analyzed: protocol 1, NHS was carried out in two steps using TEOAE; protocol 2, NHS was carried out in two steps using AABR; and protocol 3, NHS was carried out in one step, using the two procedures - testing with TEOAE followed by a retest with AABR for all the newborns who did not pass the TEOAE testing. RESULTS: although there was no statistically significant difference when comparing the referral rates to audiological diagnosis obtained in protocols using TEOAE and AABR, the protocol using TEOAE referred four times more newborns. Protocol 3 presented the highest referral rate, with a statistically significant difference when compared to protocols 1 and 2. CONCLUSIONS: the false-positive rate and consequently specificity were better for the protocol using AABR, followed respectively by the protocol using TEOAE and using both TEOAE and AABR.

Avaliação de serviços de saúde auditiva sob a perspectiva do usuário: proposta de instrumento

PURPOSE: To verify the applicability of a questionnaire for the assessment of hearing health services, under the perspective of the users. METHODS: The questionnaire was inspired on the study conducted by the Hearing and Communication Group, and presents 18 questions focused on the following dimensions: access to the service, hearing evaluation, personal attendance, family benefits, communication and information, and professional competence. Each question of this instrument was presented in a graduation scale of five points. The casuistic comprised 53 patients (or caregiver), that were invited, by the reception professionals, to answer to the questionnaire. Data were calculated in percentage, and the score for each domain and the total score were established. Inferential statistic tests were applied, adopting a significant level of 5%, in order to verify the influences of demographic characteristics on the total score. RESULTS: The score for the access domain was 62.25%, for hearing evaluation was 85.96%, for personal attendance was 82.05%, for family benefits was 68.57%, for the domain communication and information was 79.13%, for professional competence was 97.39%, and the total score was 70.65%. It was verified that patients with lower schooling levels, lesser time attending the service, and those that had already received the hearing aid obtained higher total scores on the questionnaire. CONCLUSION: The questionnaire used in the present study proved to be easily applicable in hearing health services; however, its application on national level is necessary, so that standardization and reliability and validity can be established.

Contribuições para análise da política de saúde auditiva no Brasil

ABSTRACT Purpose: To quantity the procedures related to hearing aid fitting included in Hearing Health Care National Policy ( Tabela SUS ). Methods: Data about fitting procedures included in Tabela SUS were gathered in the website www.datasus.gov.br. After data col-lection, it was conducted the organization and descriptive analysis of the production of ambulatory consults registered by hearing health services in Brazil, during the period from November 2004 to July 2010. Data were statistically analyzed. Results: Regarding procedures related to dispensing hearing aids in national territory, in 2006, speech-language therapy exceeded the amount obtained by hearing aid fitting, and audiological follow-up was little frequent. Hearing aids with technologies B and C have been adapted more than hearing aids with technology A, and the use of measures with a real-ear measurement or 2cc coupler in the adaptation of hearing aids is uncommon, in comparison to functional gain measures. Conclusion: There has been great progresses in the area of hearing impaired attention in the country, but it is necessary to improve the audiological follow-up to hearing aid users, and to review procedures such as the real-ear measurement and technologies of hearing aids.

Frequency Modulation System and speech perception in the classroom: a systematic literature review

PURPOSE This review aimed at presenting the benefits regarding the speech perception in noise shown by children who wear hearing aid devices and/or cochlear implants with the Frequency Modulation (FM) System at school. RESEARCH STRATEGY A bibliographic survey was conducted in an electronic database with standardized search until the year 2012, and a manual search was performed by using specific keywords. SELECTION CRITERIA For the selection and evaluation of the scientific studies chosen in the search, criteria were established covering the following aspects: type of study, participants, adopted intervention, and evaluation of results. DATA ANALYSIS The FM system was verified to improve speech perception and speech threshold in noise in all studies. RESULTS Regarding the performance as to type, the best results were obtained when children used the personal FM system, followed by the table and the sound field systems. CONCLUSION After extensive review of national and international literature, it was concluded that the studies indicate the need for further research concerning mainly the impact of the FM system on the school performance of children who have sensory devices coupled to the FM system. Findings in the literature with relation to the publications focused on speech perception in noise did not relate educational and auditory aspects.

Questionnaires on satisfaction of amplification in children: a systematic review.

PURPOSE To perform a systematic review of the literature on questionnaires to assess the benefits of using hearing aids in children. METHODS A literature search was conducted in the data-bases Web of Science and Virtual Health Library (BIREME). The selection criteria included: title consistent with the purpose of this review; participants necessarily being children using hearing aids; and questionnaires to assess the benefits and satisfaction. RESULTS More evidence was found in studies that used the scale Parents Evaluation of Aural/Oral Performance of Children (PEACH), making it possibly the most consistent scale on the subjective evaluation of the use of amplification in children. CONCLUSION There is a paucity of studies with this approach; however, the results showed the importance of researches in this area, which turns the subject into an important field of research.PURPOSE This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. METHODS The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. RESULTS The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (p<0.0001). Additionally, a significant association among TMD severity and palpation of the TMJ (p=0.0168), of masticatory muscles (p<0.0001), and of cervical muscles (p<0.0001) was verified. Also, there was a significant association between the frequency of headaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. CONCLUSION The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.

FALHAS TÉCNICAS DOS APARELHOS DE AMPLIFICAÇÃO SONORA INDIVIDUAL DISPENSADOS PELO SISTEMA ÚNICO DE SAÚDE

Purpose : to investigate about repair issues of hearing aids at National Health System.Methods : it was analyzed hearing aids technical failures whose patients had showed complaints concerning the device on five different services considering the period from January to May 2009, analyzed by descriptive statistic.Results : the main technical failures found were: 37.44% of failures on amplifier, 25.59% of failures on microphone. Related to the device’s technological sort and category it’s verified that the behind the ear hearing aids and of category A presented higher technical failure incidence. It’s also observable that the devices presented utility life of 22 months on average before presenting any technical failure. In the majority of the population studied, the cost for the repair of these devices was between R

Questionários sobre a satisfação da amplificação em crianças: revisão sistemática

500,00 and

Influência do tempo de vida na pesquisa das emissões otoacústicas evocadas transientes em recém-nascidos

1000.00. From the perception of hearing aids failure by the patient, 51.82% contacted the service seeking for care and 61% of analyzed hearing aids were still on guarantee term and they were fixed by technical assistance without additional cost to patient.Conclusion : the main technical failure found was failures on amplifier. The behind the ear hearing aids and of category A presented higher technical failure incidence.

Questionário para monitoramento do desenvolvimento auditivo e de linguagem no primeiro ano de vida

PURPOSE To perform a systematic review of the literature on questionnaires to assess the benefits of using hearing aids in children. METHODS A literature search was conducted in the data-bases Web of Science and Virtual Health Library (BIREME). The selection criteria included: title consistent with the purpose of this review; participants necessarily being children using hearing aids; and questionnaires to assess the benefits and satisfaction. RESULTS More evidence was found in studies that used the scale Parents Evaluation of Aural/Oral Performance of Children (PEACH), making it possibly the most consistent scale on the subjective evaluation of the use of amplification in children. CONCLUSION There is a paucity of studies with this approach; however, the results showed the importance of researches in this area, which turns the subject into an important field of research.PURPOSE This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. METHODS The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. RESULTS The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (p<0.0001). Additionally, a significant association among TMD severity and palpation of the TMJ (p=0.0168), of masticatory muscles (p<0.0001), and of cervical muscles (p<0.0001) was verified. Also, there was a significant association between the frequency of headaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. CONCLUSION The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.