Mestrado em Saúde Coletiva

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Nível: Mestrado Acadêmico
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Navegando Mestrado em Saúde Coletiva por Autor "Almeida, Ana Paula Santana Coelho"

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    Coordenação do Cuidado pela Atenção Primária à Saúde na Atenção às Pessoas com Doenças Crônicas na Região Norte do Espírito Santo
    (Universidade Federal do Espírito Santo, 2021-08-23) Polati, Amanda Morais; Almeida, Ana Paula Santana Coelho; https://orcid.org/0000-0001-5808-5818; http://lattes.cnpq.br/2570855705420190; https://orcid.org/0000-0003-3713-681X; http://lattes.cnpq.br/6574172043848207; Lima, Rita de Cassia Duarte; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270; Lima, Luciana Dias de; https://orcid.org/0000-0002-0640-8387; http://lattes.cnpq.br/8035094698187480
    In the last decades, there has been a significant increase in chronic diseases in the world population. Thus, it is necessary to organize health services in order to offer comprehensive and continuous care to individuals with chronic diseases, since they are frequent users of health services and need to access different points of the care network, being more susceptible to experience a fragmented care. Therefore, the development of care coordination by Primary Health Care (PHC) has been considered an essential attribute in the care of people with chronic diseases. Thus, the aim of this study was to understand the role of PHC in coordinating care for people with chronic diseases. This is a study that was developed by using two methodological approaches: a scoping review of the literature, carried out during the month of May 2021, in the MEDLINE, LILACS, Web of Science and EMBASE databases; and a study with a qualitative approach, carried out in a health region in the state of Espírito Santo, where data were collected through individual interviews with managers and health professionals, using a semi-structured script. The qualitative research data were analyzed using the thematic analysis technique proposed by Braun and Clarke. From the review, it was possible to identify some barriers in the development of care coordination in the care of people with chronic diseases, related to the integration between the different teams and services, the responsibility for care coordination and informational continuity, considering the configuration of the health services. In the qualitative approach research, the participants highlighted challenges and efforts related to the development of care coordination that cross all the pillars that compose this attribute (clinical coordination; administrative/organizational coordination; information coordination), highlighting that such challenges were intensified during the Covid-19 pandemic period. In general, it was possible to understand the complexity in the development of care coordination in the care of people with chronic diseases, and that it is necessary to intensify efforts that contribute to the realization of this attribute. Thus, it is essential that existing strategies are strengthened and that innovative proposals are carried out both in the scope of macro-management and micro-management.
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    Efeito da Atenção Primária à Saúde na Associação entre Multimorbidade e Utilização dos Serviços de Emergência
    (Universidade Federal do Espírito Santo, 2024-04-26) Lamonato, Larissa Carolina Xavier Lacerda; Sarti, Thiago Dias; https://orcid.org/0000-0002-1545-6276; http://lattes.cnpq.br/7489127535403969; Almeida, Ana Paula Santana Coelho; https://orcid.org/0000-0001-5808-5818; http://lattes.cnpq.br/2570855705420190; https://orcid.org/0000-0002-0139-5193; http://lattes.cnpq.br/4193698743184247; Facchini, Luiz Augusto; https://orcid.org/0000-0002-5746-5170; http://lattes.cnpq.br/5795415938371676; Fontenelle, Leonardo Ferreira; https://orcid.org/0000-0003-4064-433X; http://lattes.cnpq.br/9234772336296638
    This study aimed to investigate the effect of Primary Health Care (PHC) on the association between multimorbidity and emergency service utilization among adults in Brazil. It is a cross-sectional study, based on national household data from the National Health Survey conducted in 2019. The study tapped into Poisson regression to assess emergency service utilization among individuals with multimorbidity. Additionally, it has implemented the evaluation of the interaction of variables such as Family Health coverage and orientation towards PHC in these associations. Regarding the main variables of the scope analyzed in this study, the prevalence of multimorbidity found was 31.2% (95%CI 30.9-31.5), Family Health coverage was 71.8% (95%CI 71.4-72.0), and low orientation of services towards PHC was 70% (95%CI 69.1-70.9). The outcome adopted here, which is the use of emergency services, had a prevalence of 2.0% (95%CI 1.9-2.0). Analyzing the prevalence of emergency service utilization among individuals with and without multimorbidity, it was observed that the prevalence was twice as high among those with multimorbidity (3.1; 95%CI 2.9-3.3) compared to those without this condition (1.4; 95%CI 1.3-1.5). However, it was observed that individuals with multimorbidity and Family Health coverage had a 20% lower prevalence of emergency service utilization than those with multimorbidity and without Family Health coverage (PR: 0.8; 95%CI 0.6-0.9). The association between emergency service utilization and the presence of multimorbidity was not modified by the assessment of the service as highly oriented towards PHC (p = 0.956). The study showed that PHC had a positive effect on the association between multimorbidity and emergency service utilization. However, the challenge imposed by multimorbidity on the healthcare system is evident. Therefore, further research on this topic is suggested to understand the impact of PHC on health outcomes in individuals with multimorbidity.
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    Mortalidade por causas externas em crianças e adolescentes de 5 a 14 anos no Espírito Santo
    (Universidade Federal do Espírito Santo, 2021-07-26) Alves, Tatiana Feltmann; Sarti, Thiago Dias; https://orcid.org/0000000215456276; http://lattes.cnpq.br/7489127535403969; https://orcid.org/; http://lattes.cnpq.br/; Poton, Wanessa Lacerda; https://orcid.org/; http://lattes.cnpq.br/; Almeida, Ana Paula Santana Coelho; https://orcid.org/; http://lattes.cnpq.br/2570855705420190
    Introduction: Since the 1980s, external causes have stood out as a cause of morbidity and mortality in Brazil, with high rates of homicides and traffic accidents, mainly involving the male population. Espírito Santo state stands out for having the highest
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    Proporção dos Tratamentos Endodônticos Concluídos no SUS nos Municípios Brasileiros
    (Universidade Federal do Espírito Santo, 2022-08-22) Santos, Albina de Fatima Fanni; Almeida, Ana Paula Santana Coelho; https://orcid.org/0000-0001-5808-5818; http://lattes.cnpq.br/2570855705420190; https://orcid.org/; http://lattes.cnpq.br/; Lucena, Edson Hilan Gomes de; https://orcid.org/0000-0003-3431-115X; http://lattes.cnpq.br/7047172432384185; Pacheco, Karina Tonini dos Santos; https://orcid.org/0000-0002-4687-6062; http://lattes.cnpq.br/1634767264856221
    The preservation of teeth in the oral cavity is of great importance for the continuity of oral functions, helping to maintain the patient's health. The pathologies that cause acute inflammatory processes, periapical or pulp, are some of the reasons that most lead patients to seek dental care in the SUS. The implementation of Dental Specialty Centers, through the Brasil Sorridente Program, enabled a greater offer of this specialized service. Taking into account endodontics as a specialty that helps in the maintenance of dental elements in the oral cavity, this study had the general objective to analyze the conclusion of endodontic treatments in the SUS in Brazilian municipalities, in the year 2018. The type of study was ecological, being carried out based on secondary data in the public domain and at the municipal aggregation level. Data were taken from the National Registry of Health Establishments, from the SUS. Outpatient Information System, IBGE, and from the latest evaluation of the Program for Improving Access and Quality of Dental Specialty Centers. Analysis of the collected data were organized in a database to be analyzed and compared with the completeness of endodontic treatments, based on the available literature. Variables from the Access and Quality Improvement Program for Dental Specialty Centers and sociodemographic variables were used to better understand these results. The results of the study showed that the highest performance regarding specialized endodontic services in the SUS was associated with municipalities with smaller population sizes, with lower HDI-M, with lower dental plan coverage and with better performance in the 2nd cycle of the PMAQ CEO. In addition to investments in the structure and work process of the CEO, the improvement of public endodontic dental services in Brazil involves positive impacts on the country's oral health after the implementation of the PNSB and the principle of equity in specialized endodontic care in the SUS, given its positive impact especially in small municipalities and with less social development.
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    Tradução e adaptação transcultural do instrumento de transtornos alimentares : Eating Disorder Examination Questionnaire Short (EDE-QS)
    (Universidade Federal do Espírito Santo, 2024-08-03) Pedrosa, Maria Amália Accari; Viana, Maria Carmen Moldes ; https://orcid.org/; http://lattes.cnpq.br/; Sarti, Thiago Dias; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Appolinario, José Carlos Carlos Borges ; https://orcid.org/; http://lattes.cnpq.br/; Almeida, Ana Paula Santana Coelho ; https://orcid.org/; http://lattes.cnpq.br/
    Eating disorders (ED) are conditions that represent a great impairment in the quality of life of the subject, both due to psychosocial repercussions and associated clinical complications. Primary Health Care (PHC) is an important mental health care center of the Psychosocial Care Network (RAPS) of the Brazilian Unified Health System (SUS), where comprehensive and longitudinal care of the user is recommended. However, in the context of ED, the international literature points out some difficulties related to primary care, such as: low recognition of symptoms, either due to the knowledge of professionals or due to the user's resistance to seeking help, late diagnosis in the face of complications, insecurity in management due to the complexity of the conditions, however, studies show that training and the provision of professional tools help in the diagnosis and coordination of the Care. Brazil is a continental country, considered to be middle-income, but with significant social inequality and access to care, including health, therefore, a clinical review of the instruments available for ED screening in PHC was carried out, considering the particularities of care in our country. In view of the search and critical analysis, an instrument with the desired characteristics was identified: application by the non specialist, fast and practical, good discriminatory power, record of applicability in different samples. Thus, the objective of this study was to translate and cross culturally adapt the EDE-QS "Eating Disorder Examination Questionnaire Short (EDE-QS)". A semantic equivalence study was carried out, based on the following steps: 1: translation by two bilingual translators with Portuguese mother tongue, 2: reconciliation between the versions by a third translator, 3: reverse translation of the final preliminary version 4: validation and reconciliation of the back translation by the original authors, 5: cultural validation of the final version of the translation by a panel of six experts 6: Pre-test in a non-clinical sample to assess the understanding of the questions; and, finally, the elaboration of the final version of the instrument The above translation steps were completed according to the protocol described. In the analysis of content validity by experts, equivalences were analyzed at the item and scale level, and S-CVI was reached: 0.93 (semantics), 0.98 (idiomatic), 0.98 (experiential), 0.98 (conceptual) (minimum acceptable of 0.83). In the comprehension assessment, all items received more than 80% of understanding, and the application time was approximately 10 minutes. The Portuguese version of the EDE-QS showed adequate semantic equivalence compared to the original. In the target population, it demonstrated good verbal comprehension and practicality related to the time of application. The availability of tools with applicability in PHC is extremely relevant for early diagnosis and coordination of levels of care, thus enabling comprehensive care for users in line with SUS principles.
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    Violência contra a mulher e utilização de serviços de saúde no Brasil : Pesquisa Nacional de Saúde, 2019
    (Universidade Federal do Espírito Santo, 2024-09-20) Quaresma, Camila Rocha Ataíde; Almeida, Ana Paula Santana Coelho ; https://orcid.org/0000-0001-5808-5818; http://lattes.cnpq.br/; Sarti, Thiago Dias ; https://orcid.org/0000-0002-1545-6276; http://lattes.cnpq.br/; https://orcid.org/0000-0002-0928-1940; http://lattes.cnpq.br/; Leite, Franciéle Marabotti Costa ; https://orcid.org/0000-0002-6171-6972; http://lattes.cnpq.br/; Rocha, Erika Maria Sampaio ; https://orcid.org/0000-0003-4347-0531; http://lattes.cnpq.br/
    Introduction: Based on the 2019 National Health Survey (PNS), carried out in partnership between IBGE, the Ministry of Health and the Oswaldo Cruz Foundation, this dissertation analyzes module V (Violence) experienced by women between 18 and 60 years of age or older and contextualizes the relationship between violence and the use of health services among women in Brazil. Objectives: analyze the relationship between violence and the use of health services among women in Brazil, and specific objectives: measure the prevalence of violence and its subtypes; measure the prevalence of use of medical consultations, hospital admissions, home emergency services and integrative and complementary practices by women in situations of violence in Brazil; identify the pattern of use of medical consultations, hospital admissions, home emergency services and integrative and complementary practices by women in situations of violence in Brazil; verify the association between violence, including its subtypes, and the use of health services. Methods: This is a population based cross-sectional study using data from the PNS 2019. Crude and adjusted prevalence rates and prevalence ratios for the use of health services were calculated by type of violence and according to sociodemographic characteristics. Results: A higher prevalence of psychological, physical and sexual violence was observed among younger black women, belonging to the single group, with poor/very poor self-rated health, with lower family income, without health insurance and no occupation. In general, women who suffered violence used health services more when compared to those who did not suffer. The services most used by women who suffered psychological, physical and sexual violence were medical consultations, followed by hospital admission and Integrative and Complementary Practices (PICs). The use of home emergency services among women who suffered physical and sexual violence reached more than double the prevalence. Final considerations: These results show that the consequence resulting from the act of violence significantly influences the place where women seek care after an episode of violence