Maria Imaculada de Fátima Freitas

Representações sociais sobre aids de pessoas acima de 50 anos de idade, infectadas pelo HIV

This study analyzes representations about AIDS in nine persons older than 50, infected by HIV. The analysis revealed representations: ‘AIDS is a constant death threat’. These were categorized and named by means of the interviewers’ statements: ‘No doctor thinks, at first, that we can have aids’; ‘AIDS isn’t cancer’; ‘to be old and have AIDS is to be discriminated twice’. The results show the importance of integral care delivery by health services to decrease the psychosocial suffering of these people.

Reliability and validity of a questionnaire on vulnerability to sexually transmitted infections among adults with chronic mental illness: PESSOAS Project

OBJECTIVE To describe reliability/validity of a semi-structured questionnaire designed to assess risk behavior to sexually transmitted diseases among adults with chronic mental illness. METHOD A cross-sectional pilot study was conducted in one psychiatric hospital and one mental health outpatient clinic. Clinical, behavioral and demographic data were collected from semi-structured interviews and medical charts. One-hundred and twenty patients were randomly selected from pre-defined lists in both centers while 89 (74%) were interviewed, indicating 26% nonparticipation rate. Protocol, participation rates, consent form and feasibility issues were assessed. The semi-structured interview was evaluated with regard to reliability (intra- and inter-rater) and construct validity by randomly repeating the interviews in a 1:1 ratio up to one-week interval. Reliability was estimated by percent agreement and Kappa statistics (95% confidence interval). Construct validity was assessed by Grade of Membership model. RESULTS Kappa statistics ranged from 0.40 to 1.00 for most variables. Grade of Membership analysis generated three profiles. Profile one was represented by mostly women with no condom use in stable relationships; profile two revealed mostly men in stable relationship but with multiple risk behaviors; while profile three indicated a higher proportion of licit or illicit substance use. CONCLUSIONS Reliability and construct validity assessment using Grade of Membership analysis indicated that the semi-structured interview was suitable for capturing risk behavior among patients with chronic mental illness.

Social representations about aids in people over 50, infected by HIV

This study analyzes representations about AIDS in nine persons older than 50, infected by HIV. The analysis revealed representations: ‘AIDS is a constant death threat’. These were categorized and named by means of the interviewers’ statements: ‘No doctor thinks, at first, that we can have aids’; ‘AIDS isn’t cancer’; ‘to be old and have AIDS is to be discriminated twice’. The results show the importance of integral care delivery by health services to decrease the psychosocial suffering of these people.

Barreiras e aspectos facilitadores da adesão à terapia antirretroviral em Belo Horizonte-MG

The aim of this study was to know the constraining and facilitating aspects of adherence to highly active antiretroviral therapy (HAART) among people with HIV/AIDS. This was a qualitative study, carried out with 26 individuals receiving HAART and assisted by a referral service in Belo Horizonte, Minas Gerais, Brazil. The analysis of the interviews regarding the constraints found by users, resulted in categories relating to Day-by-day life, HIV representations, and the complexity of the treatment. As for the facilitating aspects, the categories found were absence of side effects, remembering the symptoms of the disease, improved survival, and influences from the social networks. Results have shown the importance of an effective follow-up so that health care professionals can build strategies to improve adherence to HAART together with the individuals.The aim of this study was to know the constraining and facilitating aspects of adherence to highly active antiretroviral therapy (HAART) among people with HIV/AIDS. This was a qualitative study, carried out with 26 individuals receiving HAART and assisted by a referral service in Belo Horizonte, Minas Gerais, Brazil. The analysis of the interviews regarding the constraints found by users, resulted in categories relating to Day-by-day life, HIV representations, and the complexity of the treatment. As for the facilitating aspects, the categories found were absence of side effects, remembering the symptoms of the disease, improved survival, and influences from the social networks. Results have shown the importance of an effective follow-up so that health care professionals can build strategies to improve adherence to HAART together with the individuals.

Representations of Primary Care Professionals about the Occupational Risk of HIV Infection

Este e um estudo qualitativo, fundamentado na Teoria das Representacoes Sociais, com profissionais que atuam na atencao primaria, sobre o risco de infeccao pelo HIV, ao qual estao expostos no cotidiano do trabalho. Foram entrevistados doze profissionais medicos e enfermeiras que atuam em dois centros de saude no municipio de Belo Horizonte, MG, Brasil. A analise final se deu com a saturacao das informacoes, pelo metodo proposto pela Analise Estrutural de Narracao. Os resultados desvelaram que os profissionais de saude entrevistados conhecem o risco de infeccao em seu cotidiano de trabalho, representando-o como muito baixo na atencao basica, porque o relacionam a complexidade tecnologica, que consideram nao existir no nivel de assistencia em que atuam. Acreditam que o uso de equipamentos de protecao individual pode minimizar os riscos e que, hoje, nenhum profissional da atencao basica deixa de atender pacientes por medo de se infectar, mesmo nao utilizando todas as precaucoes recomendadas.This was a qualitative study, based on the Social Representations Theory, with professionals that work in primary care, about the risk of HIV infection to which they are exposed in their quotidian work routine. Twelve physicians and nurses who work in two Health Centers in the city of Belo Horizonte, MG, Brazil, were interviewed. The final analysis, carried out using the saturation of information criterion, was based on the method proposed by Structural Analysis of Narrative. The results show that the health professionals interviewed knew the infection risk in their work routine, representing it as very low in primary care, because they relate it to technological complexity which they consider does not exist in the level of assistance in which they work. They believed that the use of personal protection equipment may minimize the risks and that, nowadays, no primary care professional refuses to attend a patient due to fear of infection, even if not using all the recommended precautions.

Avaliação da implantação do Método Canguru por gestores, profissionais e mães de recém-nascidos

This was a qualitative evaluation study aimed at both shedding light on the challenges and facilitating implementation of Kangaroo Care in Ministry of Health-accredited maternity care facilities in Brazil, from the standpoint of healthcare professionals and administrators and mothers of low birth weight newborns. Semi-structured on-site interviews were conducted at the maternity centers. The study used structural narrative analysis with the data analysis method. Key evaluative focal points identified were the methods importance in neonatal care and institutional support for its sustainability. As for the findings, the theoretical concept of institutional analysis was essential for achieving more in-depth reflection. Despite some resistance, the method is being implemented effectively in maternity care facilities; however, the study shows the need for periodic training and more resource allocation to enable improvement in the services infrastructure, thereby resulting in more effective humanization of care.

Representações sociais sobre a alimentação por sonda obtidas de pacientes adultos hospitalizados

Identificar e compreender as representacoes de pacientes sobre alimentacao por sonda. Entrevista aberta com 16 pacientes em uso de sondas para alimentacao. A analise das entrevistas foi fundamentada na analise de discurso. O referencial teorico adotado foi a Teoria das Representacoes Sociais. Identificou-se a existencia de uma trajetoria, na qual as representacoes vao sendo reorganizadas e reconstruidas pela experiencia, para tornar toleravel esse tratamento, comecando quando o paciente se depara com a necessidade do uso, passando pela experiencia do uso e, finalmente, tendo que se decidir pela continuidade ou nao do uso no ambiente domiciliar. Dentre as representacoes encontradas, existem algumas que contribuem para a adesao e outras para a rejeicao a esse tratamento. Conhecendo as ideias e crencas positivas e negativas sobre esse tratamento, torna-se possivel atuar de forma mais direcionada a fim de aumentar a adesao ao tratamento e satisfacao com ele.

Representações de profissionais da atenção primária sobre risco ocupacional de infecção pelo HIV

Este e um estudo qualitativo, fundamentado na Teoria das Representacoes Sociais, com profissionais que atuam na atencao primaria, sobre o risco de infeccao pelo HIV, ao qual estao expostos no cotidiano do trabalho. Foram entrevistados doze profissionais medicos e enfermeiras que atuam em dois centros de saude no municipio de Belo Horizonte, MG, Brasil. A analise final se deu com a saturacao das informacoes, pelo metodo proposto pela Analise Estrutural de Narracao. Os resultados desvelaram que os profissionais de saude entrevistados conhecem o risco de infeccao em seu cotidiano de trabalho, representando-o como muito baixo na atencao basica, porque o relacionam a complexidade tecnologica, que consideram nao existir no nivel de assistencia em que atuam. Acreditam que o uso de equipamentos de protecao individual pode minimizar os riscos e que, hoje, nenhum profissional da atencao basica deixa de atender pacientes por medo de se infectar, mesmo nao utilizando todas as precaucoes recomendadas.This was a qualitative study, based on the Social Representations Theory, with professionals that work in primary care, about the risk of HIV infection to which they are exposed in their quotidian work routine. Twelve physicians and nurses who work in two Health Centers in the city of Belo Horizonte, MG, Brazil, were interviewed. The final analysis, carried out using the saturation of information criterion, was based on the method proposed by Structural Analysis of Narrative. The results show that the health professionals interviewed knew the infection risk in their work routine, representing it as very low in primary care, because they relate it to technological complexity which they consider does not exist in the level of assistance in which they work. They believed that the use of personal protection equipment may minimize the risks and that, nowadays, no primary care professional refuses to attend a patient due to fear of infection, even if not using all the recommended precautions.

Riscos para doenças crônicas não transmissíveis na ótica de participantes do Vigitel

O objetivo do presente estudo foi interpretar reflexoes de grupos da populacao, por faixa etaria, sobre risco de adoecer pelas doencas cronicas nao transmissiveis (DCNT), como parte do eixo qualitativo do projeto Vigitel que monitora a prevalencia de fatores de risco para DCNT no Brasil. Procedimentos metodologicos a coleta de dados foi realizada por meio de grupos focais da amostra de Belo Horizonte, MG, de 2008, considerando que nao existe, em estudos desse tipo, a necessidade de validacao por amostragem abrangente. O interesse e aprofundar determinado assunto que podera ser comparado, posteriormente, a outros estudos. Resultados mostraram que jovens conhecem os riscos para DCNT, mas consideram que viver sem arriscar-se e impossivel. Sujeitos de 31 a 50 anos estao informados e conscientizados, mas querem continuar vivendo sem preocupacao com a saude, negociando, consigo mesmos, medidas pessoais de risco. Pessoas acima de 51 anos consideram riscos para DCNT inerentes a condicao humana, porem maiores, devido a uma vida “desregrada”, e tem medo, buscando se cuidar centrados na assistencia medica. Conclusoes as reflexoes dos grupos apontam representacoes centradas na impossibilidade de se considerar a saude em primeiro plano e constantemente, na vida cotidiana. Existe desejo de viver prazeres e satisfacoes, que, muitas vezes, nao sao coerentes com a determinacao de ser saudavel. Alem disso, ha a necessidade humana de transgressoes para se sentir vivo e mais forte que a morte. Abordagens interdisciplinares que relativizem o peso dessas representacoes para a incorporacao de modos de vida saudaveis, coletiva e autonomamente, sao fundamentais.

Social representations associated with tube feeding among adult hospitalized patients

Identificar e compreender as representacoes de pacientes sobre alimentacao por sonda. Entrevista aberta com 16 pacientes em uso de sondas para alimentacao. A analise das entrevistas foi fundamentada na analise de discurso. O referencial teorico adotado foi a Teoria das Representacoes Sociais. Identificou-se a existencia de uma trajetoria, na qual as representacoes vao sendo reorganizadas e reconstruidas pela experiencia, para tornar toleravel esse tratamento, comecando quando o paciente se depara com a necessidade do uso, passando pela experiencia do uso e, finalmente, tendo que se decidir pela continuidade ou nao do uso no ambiente domiciliar. Dentre as representacoes encontradas, existem algumas que contribuem para a adesao e outras para a rejeicao a esse tratamento. Conhecendo as ideias e crencas positivas e negativas sobre esse tratamento, torna-se possivel atuar de forma mais direcionada a fim de aumentar a adesao ao tratamento e satisfacao com ele.