Thiago Moura de Araújo

Depressão pós-parto em puérperas: conhecendo interações entre mãe, filho e família

OBJETIVO: Conhecer a interacao de puerperas, que apresentam depressao pos-parto, com seus filhos e compreender a percepcao de familiares sobre a doenca e cuidados maternos prestados por essas puerperas. METODOS: Estudo qualitativo de carater exploratorio que teve como sujeitos do estudo quatro puerperas com depressao pos-parto, acompanhadas em um Centro de Atencao Psicossocial do municipio de Quixada - CE e quatro familiares. Foram realizadas visitas domiciliarias para a execucao de entrevistas em profundidade. Os dados foram analisados conforme a tecnica de analise de conteudo proposta por Morse e Field. RESULTADOS: As principais alteracoes emocionais relatadas foram o choro facil e nervosismo. As puerperas sentiam-se frustradas e/ou inseguras quanto ao exercicio da maternidade. Como agravante foi observado que familiares desconheciam o problema da depressao pos-parto. CONCLUSAO: O cuidado de enfermagem nessa situacao deve comecar no pre-natal com avaliacao da auto-estima, da rede de suporte social e da satisfacao das futuras maes.ABSTRACTObjectives: To study the interaction of puerperal women who have postpartum depression and to understand the perception of familyabout the disease and maternal care provided by these mothers. Methods: This is an exploratory and qualitative study which had as a subjectof study four puerperal women (with postpartum depression, being followed at the Psychosocial Care Center in the municipality ofQuixada, state of Ceara) and four relatives. Home visits were made to carry out the interviews. The data were analyzed according to thecontent analysis technique proposed by Morse and Field. Results: The main changes reported were emotional easy-tears and nervousness.The puerperal women were frustrated and/or lacking confidence in the exercise of motherhood. To make matters worse it was obser ved thatthe families were unaware of the postpartum depression problem. Conclusion: Nursing care in this situation should begin assessing theprenatal self-esteem, the received social support from the network and the mother satisfaction.

Postpartum depression in puerperal women: knowing the interactions among mother, son and family

OBJETIVO: Conhecer a interacao de puerperas, que apresentam depressao pos-parto, com seus filhos e compreender a percepcao de familiares sobre a doenca e cuidados maternos prestados por essas puerperas. METODOS: Estudo qualitativo de carater exploratorio que teve como sujeitos do estudo quatro puerperas com depressao pos-parto, acompanhadas em um Centro de Atencao Psicossocial do municipio de Quixada - CE e quatro familiares. Foram realizadas visitas domiciliarias para a execucao de entrevistas em profundidade. Os dados foram analisados conforme a tecnica de analise de conteudo proposta por Morse e Field. RESULTADOS: As principais alteracoes emocionais relatadas foram o choro facil e nervosismo. As puerperas sentiam-se frustradas e/ou inseguras quanto ao exercicio da maternidade. Como agravante foi observado que familiares desconheciam o problema da depressao pos-parto. CONCLUSAO: O cuidado de enfermagem nessa situacao deve comecar no pre-natal com avaliacao da auto-estima, da rede de suporte social e da satisfacao das futuras maes.ABSTRACTObjectives: To study the interaction of puerperal women who have postpartum depression and to understand the perception of familyabout the disease and maternal care provided by these mothers. Methods: This is an exploratory and qualitative study which had as a subjectof study four puerperal women (with postpartum depression, being followed at the Psychosocial Care Center in the municipality ofQuixada, state of Ceara) and four relatives. Home visits were made to carry out the interviews. The data were analyzed according to thecontent analysis technique proposed by Morse and Field. Results: The main changes reported were emotional easy-tears and nervousness.The puerperal women were frustrated and/or lacking confidence in the exercise of motherhood. To make matters worse it was obser ved thatthe families were unaware of the postpartum depression problem. Conclusion: Nursing care in this situation should begin assessing theprenatal self-esteem, the received social support from the network and the mother satisfaction.

Drug interactions in Brazilian type 2 diabetes patients.

The aim of this paper is to identify the prevalence of the most frequent drug interactions in patients using oral antidiabeticos and their association with capillary glucose and medication adherence. In total, 579 type 2 diabetes mellitus patients from 12 health institutions in Fortaleza, Brazil were interviewed in 2009. A form was applied, including questions on medication use, comorbidities, lifestyle, body mass index and random capillary glucose. Results revealed that 26.7% used five or more different drugs simultaneously and daily. Statistically significant drug interactions occurred between antidiabeticos and diuretics, angiotensin-converting enzyme inhibitors, anti-lipidaemics and corticoids. No significant association was found between polypharmacy, medication adherence and glucose. It is important for nurses, in consensus with other health professionals, to consider the possibility of other drugs that mean less risk for diabetes patients’ glucose control or of increased antidiabetics doses.The aim of this paper is to identify the prevalence of the most frequent drug interactions in patients using oral antidiabéticos and their association with capillary glucose and medication adherence. In total, 579 type 2 diabetes mellitus patients from 12 health institutions in Fortaleza, Brazil were interviewed in 2009. A form was applied, including questions on medication use, comorbidities, lifestyle, body mass index and random capillary glucose. Results revealed that 26.7% used five or more different drugs simultaneously and daily. Statistically significant drug interactions occurred between antidiabéticos and diuretics, angiotensin-converting enzyme inhibitors, anti-lipidaemics and corticoids. No significant association was found between polypharmacy, medication adherence and glucose. It is important for nurses, in consensus with other health professionals, to consider the possibility of other drugs that mean less risk for diabetes patients glucose control or of increased antidiabetics doses.

Uso de medicamentos, glicemia capilar e índice de massa corpórea em pacientes com diabetes mellitus

Objetivo-se relacionar el uso de medicamentos con la glucemia y indice de masa corporal en pacientes con diabetes mellitus tipo 2. Fue realizado un estudio transversal, entre enero y julio de 2009, en las casas de 437 usuarios de 12 centros de salud en Fortaleza-CE. Se administro una encuesta sobre la glucemia, indice masa corporal y el uso de medicamentos. Aproximadamente 99% de los sujetos con glucemia clasificada como alterada no usaban diariamente calcio (p = 0,04). Entre las personas con niveles de glucemia clasificados como normales, 93% no utilizaban antidepresivos / ansioliticos (p = 0,02). Entre las personas con indice de masa corporal normal, 45,5% usaban inhibidor de la ECA contra la hipertension (p = 0,03). El uso diario de farmacos inhibidores de la ECA, antidepresivos / ansioliticos y el calcio se asocio con el indice de masa corporal y la glucemia, respectivamente. Es importante que los enfermeros controlen continuamente la situacion nutricional y los niveles de glucosa de las personas con diabetes, especialmente los que utilizan multiplos farmacos simultaneamente.This research aimed to relate medication use with blood glucose and body mass index in subjects with type 2 diabetes mellitus. It was performed a cross-sectional study, between January and July 2009, at the homes of 437 users of 12 health centers in Fortaleza-CE. We administered a survey about blood glucose, body mass index and medication use. Approximately 99% of study subjects with altered glucose classified as not using daily calcium (p = 0.04). Among those with normal blood glucose levels classified as around 93% did not use daily antidepressants / anxiolytics (p = 0.02). Among those with DM 2 normal body mass index, 45.5% were using daily anti-hypertensive ACE-inhibitor class (p = 0.03). Daily use of ACE inhibitor drugs, antidepressants / anxiolytics and calcium was associated with body mass index and glucose, respectively. It is important for nurses to assess body weight and blood glucose in patients with diabetes, particularly those that are under continuous medication.

Health professionals difficulties in preventing nosocomial infections

ABSTRACT Objective : to know the difficulties encountered by professionals working in the Intensive Care Unit before the challenge of controlling nosocomial infections. Methodology : they were participants of the qualitative research nine professionals from the university hospital in June 2009. A semi-structured script was used as an instrument of data collection about possible problems for the control of nosocomial infections and interviews. The results were organized by categorical technique, and then the data were analyzed in light of reference to Morse and Field. The study was approved by the Ethics in Research of the Institute Dr. Jose Frota, protocol number 86145/08. Results : the main problems in combating the NI were the inadequate physical space, the long working day, combined with high turnover of patients. The lack of infrastructure service in the implementation of a work within appropriate aseptic conditions was also mentioned. Conclusions : it is important the partnership between the intensive care unit along with Committee of the Hospital Infection Control are co-involved in the control and prevention of nosocomial infections. Descriptors : cross infection; infection control; infection control practitioners; quality of health care; intensive care units; working environment; burnout professional . RESUMO Objetivo : conhecer as dificuldades encontradas pelos profissionais que atuam numa Unidade de Terapia Intensiva diante do desafio do controle das infeccoes hospitalares. Metodologia : estudo qualitativo desenvolvido com nove profissionais de saude de um hospital escola durante o periodo de junho de 2009. Adotou-se como instrumento da coleta de dados, entrevistas e roteiro semi-estruturado sobre possiveis problemas detectados para o controle das infeccoes hospitalares. Os resultados foram organizados pela tecnica categorial, em seguida analisados a luz do referencial de Morse e Field. A pesquisa foi autorizada pelo Comite de Etica em Pesquisa do Instituto Doutor Jose Frota, protocolo 86145/08. Resultados : o espaco fisico inadequado, jornada laboral extensa juntamente com a grande rotatividade de pacientes foram os principais problemas verificados no combate as infeccoes hospitalares. A falta de infra-estrutura do servico na implementacao de um trabalho dentro de condicoes assepticas adequadas tambem foi citado. Conclusoes : a parceria entre a unidade de terapia intensiva juntamente com a Comissao de Controle de Infeccao Hospitalar e um desafio importante para que ambos sejam co-participantes no controle e prevencao das infeccoes hospitalares. Descritores : infeccao hospitalar; controle de infeccoes; profissionais controladores de infeccao; qualidade da assistencia a saude; unidades de terapia intensiva; ambiente de trabalho; esgotamento profissional. RESUMEN Objetivo : conhecer las dificultades encontradas por los profesionales que trabajan en la Unidad de Cuidados Intensivos ante el desafio de controlar las infecciones nosocomiales. Metodologia : los participantes del estudio cualitativo fueron nueve profesionales del hospital universitario durante el mes de junio de 2009. Se utilizo como un instrumento de recoleccion de datos entrevistas e un guion semi-estructurado acerca de posibles problemas detectados en el control de infecciones nosocomiales. l os resultados fueron organizados de acuerdo a la tecnica categorial y, a continuacion, los datos analizados a la luz del referencial de Morse y Field . El estudio fue aprobado por el Comite de etica en la investigacion del Instituto Dr Jose Frota, protocolo 86145/08 . Resultados : la insuficiencia de espacio fisico, el largo dia de trabajo asociados con la alta rotacion de pacientes fueron los principales problemas en la lucha contra las infecciones hospitalares. La falta de servicos de infraestructura en la ejecucion de una obra en condiciones adecuadas de asepsia. Tambien se menciono. Conclusiones : es importante la colaboracion entre la unidad de cuidados intensivos, junto con el Comite de Control da Infecci on Hospitalaria a fin de que ambos sean co-implicados en el control y la prevencion de las infecciones hospitalares. Descriptores : infeccion hospitalaria; control de infecciones; profesionales para control de infecciones; calidad de la atencion de salud; unidades de terapia intensiva; ambiente de trabajo; agotamiento profesional.

Uso de fármacos, glucemia e índice de masa corporal en pacientes con diabetes mellitus

Objetivo-se relacionar el uso de medicamentos con la glucemia y indice de masa corporal en pacientes con diabetes mellitus tipo 2. Fue realizado un estudio transversal, entre enero y julio de 2009, en las casas de 437 usuarios de 12 centros de salud en Fortaleza-CE. Se administro una encuesta sobre la glucemia, indice masa corporal y el uso de medicamentos. Aproximadamente 99% de los sujetos con glucemia clasificada como alterada no usaban diariamente calcio (p = 0,04). Entre las personas con niveles de glucemia clasificados como normales, 93% no utilizaban antidepresivos / ansioliticos (p = 0,02). Entre las personas con indice de masa corporal normal, 45,5% usaban inhibidor de la ECA contra la hipertension (p = 0,03). El uso diario de farmacos inhibidores de la ECA, antidepresivos / ansioliticos y el calcio se asocio con el indice de masa corporal y la glucemia, respectivamente. Es importante que los enfermeros controlen continuamente la situacion nutricional y los niveles de glucosa de las personas con diabetes, especialmente los que utilizan multiplos farmacos simultaneamente.This research aimed to relate medication use with blood glucose and body mass index in subjects with type 2 diabetes mellitus. It was performed a cross-sectional study, between January and July 2009, at the homes of 437 users of 12 health centers in Fortaleza-CE. We administered a survey about blood glucose, body mass index and medication use. Approximately 99% of study subjects with altered glucose classified as not using daily calcium (p = 0.04). Among those with normal blood glucose levels classified as around 93% did not use daily antidepressants / anxiolytics (p = 0.02). Among those with DM 2 normal body mass index, 45.5% were using daily anti-hypertensive ACE-inhibitor class (p = 0.03). Daily use of ACE inhibitor drugs, antidepressants / anxiolytics and calcium was associated with body mass index and glucose, respectively. It is important for nurses to assess body weight and blood glucose in patients with diabetes, particularly those that are under continuous medication.

Drug use, blood glucose and body mass index in patients with diabetes mellitus

Objetivo-se relacionar el uso de medicamentos con la glucemia y indice de masa corporal en pacientes con diabetes mellitus tipo 2. Fue realizado un estudio transversal, entre enero y julio de 2009, en las casas de 437 usuarios de 12 centros de salud en Fortaleza-CE. Se administro una encuesta sobre la glucemia, indice masa corporal y el uso de medicamentos. Aproximadamente 99% de los sujetos con glucemia clasificada como alterada no usaban diariamente calcio (p = 0,04). Entre las personas con niveles de glucemia clasificados como normales, 93% no utilizaban antidepresivos / ansioliticos (p = 0,02). Entre las personas con indice de masa corporal normal, 45,5% usaban inhibidor de la ECA contra la hipertension (p = 0,03). El uso diario de farmacos inhibidores de la ECA, antidepresivos / ansioliticos y el calcio se asocio con el indice de masa corporal y la glucemia, respectivamente. Es importante que los enfermeros controlen continuamente la situacion nutricional y los niveles de glucosa de las personas con diabetes, especialmente los que utilizan multiplos farmacos simultaneamente.This research aimed to relate medication use with blood glucose and body mass index in subjects with type 2 diabetes mellitus. It was performed a cross-sectional study, between January and July 2009, at the homes of 437 users of 12 health centers in Fortaleza-CE. We administered a survey about blood glucose, body mass index and medication use. Approximately 99% of study subjects with altered glucose classified as not using daily calcium (p = 0.04). Among those with normal blood glucose levels classified as around 93% did not use daily antidepressants / anxiolytics (p = 0.02). Among those with DM 2 normal body mass index, 45.5% were using daily anti-hypertensive ACE-inhibitor class (p = 0.03). Daily use of ACE inhibitor drugs, antidepressants / anxiolytics and calcium was associated with body mass index and glucose, respectively. It is important for nurses to assess body weight and blood glucose in patients with diabetes, particularly those that are under continuous medication.

Readiness for enhanced self-health management among people with diabetes mellitus

OBJETIVO: identificar o diagnostico de enfermagem disposicao para controle aumentado do regime terapeutico entre pessoas com diabetes tipo 2 aderentes ao tratamento farmacologico. METODOS: A amostra foi constituida de 579 sujeitos de 12 servicos de atencao primaria que receberam visitas domiciliares. Para determinar a adesao ao tratamento farmacologico foi realizado o teste da contagem de comprimidos. Naqueles classificados como aderentes foi aplicado um check list com as caracteristicas definidoras do diagnostico de enfermagem disposicao para controle aumentado do regime terapeutico. [...]Objective: To identify the nursing diagnosis, readiness for enhanced self-health management, among people with type 2 diabetes who are adherent to pharmacological treatment. Methods: The sample consisted of 579 subjects from 12 primary care services who received home visits. To determine adherence to the pharmacological treatment, the pill count test was conducted. Those classified as adherent were given a checklist with the defining characteristics of the nursing diagnosis, readiness for enhanced self-health management. Results: Subjects with type 2 diabetes who presented with the nursing diagnosis were not alcoholics (p = 0.003), did not miss their diabetes consultations (p = 0.000), and had no difficulties / inappropriate behaviors with regard to taking their oral antidiabetic agents (p = 0.000). Conclusion: The identification of human responses to the clinical treatment of type 2 diabetes should be continuous, so that nurses can understand the factors involved in the readiness to enhance therapeutic control.

Disposição para controle aumentado do regime terapêutico entre pessoas com diabetes mellitus

OBJETIVO: identificar o diagnostico de enfermagem disposicao para controle aumentado do regime terapeutico entre pessoas com diabetes tipo 2 aderentes ao tratamento farmacologico. METODOS: A amostra foi constituida de 579 sujeitos de 12 servicos de atencao primaria que receberam visitas domiciliares. Para determinar a adesao ao tratamento farmacologico foi realizado o teste da contagem de comprimidos. Naqueles classificados como aderentes foi aplicado um check list com as caracteristicas definidoras do diagnostico de enfermagem disposicao para controle aumentado do regime terapeutico. [...]Objective: To identify the nursing diagnosis, readiness for enhanced self-health management, among people with type 2 diabetes who are adherent to pharmacological treatment. Methods: The sample consisted of 579 subjects from 12 primary care services who received home visits. To determine adherence to the pharmacological treatment, the pill count test was conducted. Those classified as adherent were given a checklist with the defining characteristics of the nursing diagnosis, readiness for enhanced self-health management. Results: Subjects with type 2 diabetes who presented with the nursing diagnosis were not alcoholics (p = 0.003), did not miss their diabetes consultations (p = 0.000), and had no difficulties / inappropriate behaviors with regard to taking their oral antidiabetic agents (p = 0.000). Conclusion: The identification of human responses to the clinical treatment of type 2 diabetes should be continuous, so that nurses can understand the factors involved in the readiness to enhance therapeutic control.

Disposición para el control aumentado del régimen terapéutico entre personas con diabetes mellitus

OBJETIVO: identificar o diagnostico de enfermagem disposicao para controle aumentado do regime terapeutico entre pessoas com diabetes tipo 2 aderentes ao tratamento farmacologico. METODOS: A amostra foi constituida de 579 sujeitos de 12 servicos de atencao primaria que receberam visitas domiciliares. Para determinar a adesao ao tratamento farmacologico foi realizado o teste da contagem de comprimidos. Naqueles classificados como aderentes foi aplicado um check list com as caracteristicas definidoras do diagnostico de enfermagem disposicao para controle aumentado do regime terapeutico. [...]Objective: To identify the nursing diagnosis, readiness for enhanced self-health management, among people with type 2 diabetes who are adherent to pharmacological treatment. Methods: The sample consisted of 579 subjects from 12 primary care services who received home visits. To determine adherence to the pharmacological treatment, the pill count test was conducted. Those classified as adherent were given a checklist with the defining characteristics of the nursing diagnosis, readiness for enhanced self-health management. Results: Subjects with type 2 diabetes who presented with the nursing diagnosis were not alcoholics (p = 0.003), did not miss their diabetes consultations (p = 0.000), and had no difficulties / inappropriate behaviors with regard to taking their oral antidiabetic agents (p = 0.000). Conclusion: The identification of human responses to the clinical treatment of type 2 diabetes should be continuous, so that nurses can understand the factors involved in the readiness to enhance therapeutic control.