Doutorado em Saúde Coletiva

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    Associação entre Propósito de Vida, Cognição e Funcionalidade em Idosos da Região Rural da Amazônia
    (Universidade Federal do Espírito Santo, 2024-02-06) Campos, Hércules Lázaro Morais; Oliveira, Elizabete Regina Araujo; https://orcid.org/0000-0002-6616-4273; http://lattes.cnpq.br/4671078095444887; https://orcid.org/0000-0002-6919-8161; http://lattes.cnpq.br/3543724672096710; Miotto, Maria Helena Monteiro de Barros; https://orcid.org/0000-0002-3227-7608; http://lattes.cnpq.br/4289442514763843; Lima, Rita de Cássia Duarte; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270; Silva, Cristina Cristóvão Ribeiro da; https://orcid.org/0000-0001-6222-3232; http://lattes.cnpq.br/1322953486284487; Silva, Anna Quialheiro Abreu da; https://orcid.org/0000-0002-4168-6585; http://lattes.cnpq.br/4874881297354282
    Growing old in a developing country is a major challenge and becoming old in the rural Amazonian context enhances, instigates and makes these elderly men and women develop resilience. It is known that in developing countries rural ageing is a male phenomenon, but studies on this population have female characteristics; it is the elderly women who take part in the research and it is from them that we have the most information. OBJECTIVES: To characterize and describe the presence of cognition, functionality and life purpose in elderly people aging in rural Amazonas. METHODOLOGY: A sociodemographic questionnaire was used to assess and characterize elderly women and men aging in rural Amazonas in 2020. To assess health, cognition, functionality and purpose in life, the elderly were visited in their rural communities and/or at home. To assess cognition, the Mini-Mental State Examination (MMSE) was applied, with cut-off scores according to schooling; functionality and physical performance were assessed using the Short Physical Performance Battery (SPPB); and to assess purpose in life (PiL), the scale validated in Brazil was applied. The database analyzed in this study has n=215 observations, with no missing data.Categorical variables were presented as absolute and relative frequencies, while numerical variables were described using measures of central tendency and dispersion. Pearson's chi-square test of independence and Fisher's exact test were used to test the association between the independent variables and the Life Purpose Scale. A binomial logistic regression model was adjusted for the variables that showed statistical significance in the association test, with the OR (odds ratio) being presented for the analyses; significance was used at the 5% level. All procedures were carried out using R Studio (2023.03.1+446 "Cherry Blossom") and R (4.2.2) software. RESULTS AND DISCUSSION: Rural ageing in Amazonas, as described in this study, is also female, surrounded by women farmers, with low levels of schooling, cognitive changes that deserve attention, are partially functional and, surprisingly, have a purpose in life. The first article recorded and produced a systematic review protocol on how to grow old from a cognitive, functional and life purpose point of view in a rural context around the world; the second article produced a systematic review on how to grow old in a rural context around the world, evaluating these crosssectional studies methodologically through methodological quality and risk of bias (OSQE), and found that until April 2023 there had been no publications on life purpose in the rural elderly population around the world. Finally, the last article found the presence of life purpose in rural elderly people in the Amazon and that working even after retirement and having moderate physical function are protective for future life goals. The way we age in a rural context from a cognitive, functional and physical function perspective is still very homogeneous, diverse and depends very much on the rural region in the world where this ageing takes place. CONCLUSION: The data on how people age in rural areas is still very homogeneous, sometimes confusing and contradictory, and more elderly men need to be included in this context. Life purpose, together with age, schooling and functionality were protective factors for the health of elderly people aging in rural Amazonas. This study is the first to verify the presence of life purpose in elderly people aging in a rural context. Presenting PiL is an important and protective factor for cognition, functionality, physical function and rural ageing in the barrancas of Amazonas.
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    Consulta de enfermagem motivacional com alcoolistas: o cuidado no processo de mudança
    (Universidade Federal do Espírito Santo, 2024-03-22) Subrinho, Lucas Queiroz; Santos, Marcos Vinícius Ferreira dos; https://orcid.org/0000-0001-9788-660X; http://lattes.cnpq.br/3361334188486592; Siqueira, Marluce Mechelli de; https://orcid.org/0000-0002-6706-5015; http://lattes.cnpq.br/5309001654924097; https://orcid.org/0000-0003-3823-7153; http://lattes.cnpq.br/0193604889422442; Seabra, Paulo Rosário de Carvalho; https://orcid.org/0000-0001-8296-1021; http://lattes.cnpq.br/; Camatta, Marcio Wagner; https://orcid.org/0000-0002-4067-526X; http://lattes.cnpq.br/2745100907568785; Gomes, Maria da Penha Zago; https://orcid.org/0000-0001-5965-9000; http://lattes.cnpq.br/5282147432358662; Garcia, Maria Lúcia Teixeira; https://orcid.org/0000-0003-2672-9310; http://lattes.cnpq.br/3834218481612647
    Objective: To evaluate the effectiveness of the Motivational Nursing Consultation (CEM) in changing the behavior of alcoholics in a specialized outpatient care program at a university hospital. Methods: a quantitative, analytical, clinical, pre-experimental, longitudinal research with three moments of variable measurement. The participants were users of the Alcohol Outpatient Program of the Cassiano Antônio Moraes University Hospital of the Federal University of Espírito Santo (PAA-HUCAM-UFES), referred to the CEM, who self-reported episodes of alcohol consumption within the last 30 days, without a history of treatment by the service nurse. A total of 21 users who participated in five CEM in 90 days were included. Behavior changes were evaluated at three moments: before the intervention, in the day of the third CEM, and after the fifth CEM. Through a questionnaire composed of a biosocioeconomic and demographic survey, Depression, Anxiety and Stress Scale - Short Form (DASS-21), Short Alcohol Dependence Data (SADD), Questionnaire of Perceived Changes, brazilian version (QPC) and two adaptations of standardized instruments in the international scenario Quick Drinking Assessment Interview (FORM-90-AQ) and Readiness to Change Ruler. Data analysis was performed through relative frequency, absolute, mean and standard deviation, paired t-test and routines executed in the statistical package Stata (Stat Corp®) version 12 for effect size calculation. This study is a subproject of the umbrella project entitled “Atenção a Usuários de Álcool, Tabaco e outras Drogas num Hospital Universitário: tecendo a rede do cuidar”, approved under appearance no. 5,558,775 and CAAE: 06800219.8.0000.5071 in the Research Ethics Committee of Hucam. Results: The pattern of consumption days was reduced in all evaluated periods, with a larger effect size between T0 and T2. The same behavior was observed in the reduction of heavy consumption. There was a reduction in score and severity in signs and symptoms of depression and stress between T0 and T2. SADD also showed a score reduction, while QPC had an increase. No effects were observed on the signs and symptoms of anxiety and readiness for change. Conclusion: The CEM was effective in changing the behavior of alcoholics in terms of consumption pattern, signs and symptoms of depression and stress, SADD and perceived change in relation to treatment. It is a low-cost approach that can be applied in the care of alcoholics.
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    Covid-19 Em Gestantes E Recém-Nascidos: Situação Epidemiológica Do Espírito Santo
    (Universidade Federal do Espírito Santo, 2024-04-23) Santos, Ana Paula Brioschi Dos; Vicente, Creuza Rachel; https://orcid.org/0000-0003-0182-7969; http://lattes.cnpq.br/0530544422426629; Miranda, Angelica Espinosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; https://orcid.org/0000-0002-9701-0314; http://lattes.cnpq.br/5392815933543240; Brito, Ana Maria de; https://orcid.org/0000-0003-4347-6730; http://lattes.cnpq.br/0105337613337822; Pinto Neto, Lauro Ferreira da Silva; https://orcid.org/0000-0003-2964-8516; http://lattes.cnpq.br/1528710938091794; Prado, Thiago Nascimento do; https://orcid.org/0000-0001-8132-6288; http://lattes.cnpq.br/6388559394015871; Almeida, Márcia Valéria de Souza ; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767
    Introduction: The Coronavirus disease (COVID-19), caused by SARS-CoV2, was declared a pandemic by the World Health Organization (WHO) in 2020. Pregnancy was not initially considered a risk group, however, it was noticed that when infected, pregnant women were more likely to present a more severe clinical picture and death compared to non-pregnant reproductive-aged women, especially among low- and middle-income countries. Objective: To analyze the effects of COVID-19 on maternal and infant outcomes and the quality of data from 2020 to 2022 in Espírito Santo. Methodology: To achieve the objectives, three stages were carried out in the study. The first stage was a descriptive study using data obtained from e-SUS VS. Completeness in filling out the notification was classified as excellent (less than 5% incomplete filling), good (5% to 10%), fair (10% to 20%), poor (20% to 50%), or very poor (50% or more). The timeliness was defined by the difference between the dates of symptom onset and notification. The second stage was a retrospective cohort study among pregnant women with secondary data from the National Live Birth Information System (SINASC), the National Mortality Information System (SIM), and the e-SUS Surveillance Health System. Pregnant women confirmed for COVID-19 had a positive RT-PCR between March 2020 and May 2021, while pregnant women without COVID-19 were those without notification for the disease. Maternal death, fetal death, and stillbirth were evaluated as primary outcomes. In the third stage, a case-control study was conducted from a historical cohort of pregnant women confirmed for COVID-19 in the state of Espírito Santo between 2020 and March 2022. Cases were selected from maternal deaths confirmed by COVID-19 registered in e-SUS VS and SIM, and controls were selected from the cohort of pregnant women confirmed for COVID-19 who were cured of the disease. Results: In the first stage of the study, 8,989 notifications in pregnant women were identified. The notification for COVID-19 in e-SUS VS has 59 variables, the completeness of 53 (89.83%) variables was excellent, good, or fair in 1 (1.70%), and poor in 4 (6.77%). The timeliness had an average of 3.37 days. In the second stage, 68,673 pregnant women not notified as suspected of COVID-19 and 1,386 with a confirmed diagnosis of COVID-19 were included. Among pregnant women with COVID-19, 1,013 (73.0%) were aged 20 to 34 years, 655 (47.2%) were of mixed race, 907 (65.4%) had ≥ 8 years of schooling, in the third trimester of pregnancy (41.5%), undergoing cesarean section (64.5%). In adjusted analyzes, COVID-19 in pregnancy presented a higher risk of maternal death (relative risk [RR] 18.73 - 95% confidence interval [CI95%] 11.07-31.69), fetal death/stillbirth (RR 1.96 - CI95% 1.18 -3.25), premature birth [RR 1.18-CI95% 1.01-1.39], cesarean section (RR 1.07 - CI95% 1.02-1.11), and cesarean section before the onset of labor (RR 1.33 - CI95% 1.23-1.44). In the third stage, the sample consisted of 2,300 pregnant women, the matching of cases and controls was performed, and 37 cases and 111 controls were selected. Among the pregnant women who died, 35 (67.57%) were non-white, 26 (70.27%) had ≥ 8 years of study. 27 (72.97%) were infected in the 3rd gestational trimester, 24 (77.42%) had up to 6 prenatal consultations, and 15 (48.39%) had 3 or more previous pregnancies. Regarding the vaccination status among the deaths, 3 (8.11%) were vaccinated during pregnancy, and 36 (97.30%) had a record of COVID19 infection before the first vaccine dose, 40.54% had adynamia, and 13 (35.14%) of the pregnant women who died presented at least 1 comorbidity. In the adjusted model, the highest chance of maternal death was described among pregnant women infected in the third gestational trimester (OR 4.67 - CI95% 1.51-14.46), with adynamia (OR 4.33 - CI95% 1.41- 13.31) with at least one comorbidity in pregnancy (OR 3.82 - CI95% 1.16-12.55). Having more than 7 prenatal consultations remained with the lowest chance of progressing to death (OR 0.91 - CI95% 0.31-0.26). Conclusion: The quality of data regarding pregnant women registered in e-SUS VS was excellent. COVID-19 can contribute to unfavorable outcomes in pregnancy. The results showed that pregnant women infected with SARS-CoV-2 had a higher risk of maternal death, fetal death/stillbirth, premature birth, cesarean section, and cesarean section before the onset of labor. Factors related to prenatal care, exposure to the virus in the third trimester of pregnancy, as well as factors related to pre-existing diseases and conditions in pregnant women infected with SARS-CoV-2, increase the chance of maternal death.