Health Interventions for Preventing Climate-Sensitive Diseases: Scoping Review.

Climate variations cause public health problems, but the literature is still scarce on studies involving health interventions against climate-sensitive diseases. The objective of this review was to identify health interventions for the prevention of such diseases. We conducted a scoping review using the JBI Methodology. Six large research databases were searched (PubMed, Scopus, Web of Science, Lilacs, Embase, and Cochrane). The following inclusion criterion was used: studies addressing health interventions to prevent climate-sensitive diseases or consequences of climate on people's health. The exclusion criteria consisted of thesis, dissertations, conference proceedings, studies with unclear information/methodology, and studies not addressing climate-related health interventions. No language or date restrictions were applied. Of 733 studies identified and screened by title and abstract, 55 studies underwent full-text screening, yielding 13 studies for review. The health interventions identified were classified into three levels of management. The macro level included the use of epidemiological models, renewable energy, and policies sensitive to climate change. The meso level comprised interventions such as the creation of environmental suitability maps, urban greening, chemoprophylaxis, water security plans, and sanitation projects, among other measures. Some interventions are at the intersection, such as educational campaigns and the modification of artificial larvae sites. Finally, the micro level contained interventions such as the inspection of window screens and the use of light-colored clothing and repellents. The health interventions at the macro, meso, and micro levels and the intersection may serve as a basis for public managers to implement appropriate interventions against climate-sensitive diseases.

[Strategies for self-management support by patients with stroke: integrative review]. / Estratégias de autocuidado apoiado para pacientes com acidente vascular cerebral: revisão integrative.

OBJECTIVE: To analyze strategies for self-management support by patients with stroke in the light of the methodology of the five A's (ask, advice, assess, assist and arrange). METHODS: Integrative review conducted at the following databases CINAHL, SCOPUS, PubMed, Cochrane and LILACS. RESULTS: A total of 43 studies published between 2000 and 2013 comprised the study sample. All proposed actions in the five A's methodology and others were included. We highlight the Assist and Arrange, in which we added actions, especially with regard to the use of technological resources and joint monitoring between patients, families and professionals. No study included all five A's, which suggests that the actions of supported self-management are developed in a fragmented way. CONCLUSION: The use of five A's strategy provides guidelines for better management of patients with stroke with lower cost and higher effectiveness.

Etiological factors of chronic pain syndrome in young adults with post-coronavirus disease 2019 condition.

PURPOSE: The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions. METHODS: This was a case-control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS. FINDINGS: This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS. CONCLUSIONS: A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS. IMPLICATIONS FOR NURSING PRACTICE: The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy.

The Influence of Climate, Atmospheric Pollution, and Natural Disasters on Cardiovascular Diseases and Diabetes Mellitus in Drylands: A Scoping Review.

Objectives: In the face of escalating global aridification, this study examines the complex relationship between climate variability, air pollution, natural disasters, and the prevalence of cardiovascular disease (CVD) and diabetes mellitus (DM) in arid regions. Methods: The study conducted a scoping review of multiple databases using JBI guidelines and included 74 studies. Results: The results show that acute myocardial infarction (n = 20) and stroke (n = 13) are the primary CVDs affected by these factors, particularly affecting older adults (n = 34) and persons with hypertension (n = 3). Elevated air temperature and heat waves emerge as critical risk factors for CVD, exacerbating various cardiovascular mechanisms. Atmospheric pollutants and natural disasters increase this risk. Indirect effects of disasters amplify risk factors such as socioeconomic vulnerability (n = 4), inadequate medical care (n = 3), stress (n = 3), and poor diet (n = 2), increasing CVD and DM risk. Conclusion: The study underscores the need for nations to adhere to the Paris Agreement, advocating for reduced air pollutants, resilient environments, and collaborative, multidisciplinary research to develop targeted health interventions to mitigate the adverse effects of climate, pollution, and natural disasters.

[Evaluation of patients with stroke monitored by home care programs]. / Avaliação de pacientes com acidente vascular cerebral acompanhados por programas de assistência domiciliária.

The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%), elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8%) and instrumental (80.3 %) activities of daily living, and a low cognitive level (95.1%). Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

Factors associated with older adults' knowledge, attitude and practice on skin cancer prevention.

OBJECTIVES: to identify factors associated with older adults' knowledge, attitude and practice regarding skin cancer prevention. METHODS: this is a cross-sectional study, carried out with 120 older adults from a Basic Health Unit in Quixadá, Ceará, from September to November 2018. RESULTS: individuals aged 60 to 69 years and working were statistically associated with adequate knowledge (p=0.038). Having light skin, eyes and hair was associated with adequate attitude (p=0.030). Having skin problems, such as bleeding wounds, was associated with adequate practice (p=0.016). With regard to inappropriate behavior for skin cancer prevention, there was a statistically significant association between working or having worked under direct exposure to the sun, inadequate knowledge (p=0.036), inadequate attitude (p=0.010) and having incomplete primary education and inadequate practice (p<0.001). CONCLUSIONS: sociodemographic and clinical factors influence older adults' knowledge, attitude and practice regarding skin cancer prevention.

[Identification of the nursing diagnosis of fall risk in elderly with stroke]. / Identificação do diagnóstico de enfermagem "risco de quedas em idosos com acidente vascular cerebral.

The purpose of this study was to verify the presence of a nursing diagnosis of fall risk in elderly with stroke. Observational exploratory and cross-sectional study with descrziptive analysis. Performed in a charitable rehabilitation association in Fortaleza city, from January to March 2010, by primary source, by interviews and physical examination with elderly people who had at least one episode of stroke 37 individuals participated of which 20 (54.1%) were women, with mean age of 70.6years, and 18 (48.6%) lived with a partner and had an average of 5.2 years of study. The risk of falls was found in all elderly. Among the risk factors identified it is possible to highlight Impaired balance (100%), Age above 65 years (83.7%), and Proprioceptive deficit (83.7%). Nurses must consider the risk of falls as a nursing carefocus and implement and evaluate the results of interventions for fall prevention.

Accuracy of the clinical indicators for Readiness for enhanced health management.

PURPOSE: to analyze accuracy measures of the clinical indicators of Readiness for enhanced health management in patients with arterial hypertension and/or diabetes mellitus METHODS: prospective diagnostic accuracy study conducted with 359 patients with hypertension and/or diabetes mellitus, followed up in primary healthcare. Stratified random sampling was used to recruit participants. An assessment form was applied with sociodemographic data, health conditions, and information related to the clinical indicators under investigation. Sensitivity, specificity, predictive values, and likelihood ratios were analyzed FINDINGS: the sample was composed of 359 participants. The prevalence of Readiness for enhanced health management was 93.8%. There was a statistically significant association between the diagnosis and age under 60 years (p < 0.001), having only one chronic condition (p < 0.001), having normal blood pressure (p = 0.017) and blood glucose (p = 0.013) values, and having a nonsedentary (p = 0.026) and nonalcoholic (p = 0.044) lifestyle. All clinical indicators had high predictive values in predicting the nursing diagnosis under investigation. The indicator expresses desire to enhance management of symptoms was the most sensitive (99.7%) and specific (100%). The indicator expresses desire to enhance management of prescribed regimens was also highly specific (100%) CONCLUSION: all clinical indicators were accurate in predicting Readiness for enhanced health management IMPLICATIONS FOR NURSING PRACTICE: knowing which clinical indicators and sociodemographic/clinical characteristics best predict Readiness for enhanced health management, nurses in primary care can better plan nursing interventions and direct their goals.

Health literacy and adherence to the pharmacological treatment by people with arterial hypertension.

OBJECTIVE: To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension. METHODS: Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests. RESULTS: People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence. CONCLUSIONS: A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.

Efeito de intervenções educativas na autoeficácia de idosos da zona rural com doenças crônicas / Effect of educational interventions on self-efficacy of rural older people with chronic diseases

Objetivo: Avaliar a autoeficácia de idosos da zona rural com doenças crônicas antes e após intervenções educativas (interativa ou expositiva). Métodos: Estudo quase-experimental do tipo antes e depois, realizadoem setembro de 2016. Aplicaram-se intervenções educativas (interativa ou expositiva) com idosos acompanhados em duas Unidades Básicas de Saúde da zona rural de Senador Pompeu, Ceará. Sorteou-se qual unidade recebeu cada intervenção. Utilizou-se a escala Diabetes Empowerment Scale-Short Form para verificar o efeito das intervenções. Os dados foram analisados por estatística descritiva e testes de diferença. Resultados: Compuseram os grupos 10 (intervenção interativa) e 15 (intervenção expositiva) idosos, com média de idade entre 66,6 e 68,2 anos. Predominaram mulheres, com nível primário e baixo rendimento mensal. A maioria tinha hipertensão arterial (92%) e 24% apresentavam outra doença crônica simultânea. Os escores de autoeficácia nos dois grupos aumentaram depois das intervenções aplicadas (intervenção interativa 0,9 pontos e intervenção expositiva 0,6 pontos), com diferença estatística significante (p=0,008 e p=0,001). Dos itens avaliados, Necessidade de mudança do comportamento e Cuidar de si obtiveram menor e maior aumento das médias entre as avaliações (0,1 e 1,5, respectivamente).Conclusão: As intervenções educativas (interativa ou expositiva) aplicadas aumentaram a autoeficácia de idosos com doenças crônicas. Descritores: Autoeficácia; Educação em Saúde; Idoso; Atenção Primária à Saúde; Doença Crônica

Objective: To evaluate the self-efficacy of rural older people with chronic diseases before and after educational interventions (interactive or expository). Methods: A quasi-experimental before and after study conducted in September 2016. Educational interventions (interactive or expository) were applied with older people accompanied in two Basic Health Units in the rural area of Senador Pompeu, Ceará. The assignment of intervention to each of the units was defined by lot. The Diabetes Empowerment Scale-Short Form scale was used to verify the effect of interventions. Data were analyzed by descriptive statistics and difference tests. Results: Groups 10 (interactive intervention) and 15 (expository intervention) were composed, with a mean age between 66.6 and 68.2 years. Women with primary level and low monthly income predominated. The majority had hypertension (92%) and 24% had another simultaneous chronic disease. Self-efficacy scores in both groups increased after the applied interventions (interactive intervention 0.9 points and expository intervention 0.6 points, respectively), with a statistically significant difference (p=0.008 and p=0.001). Of the items evaluated, Need for behavior change and Taking care of oneself obtained a lower and higher increase in the means between the evaluations (0.1 and 1.5, respectively). Conclusion: The educational interventions (interactive or expository) applied increased the self-efficacy of older people with chronic diseases.Descriptors:Self efficacy; Health Education; Aged; Primary health care; Chronic disease.

Efeito de intervenções educativas na autoeficácia de idosos da zona rural com doenças crônicas / Effect of educational interventions on self-efficacy of rural older people with chronic diseases

Objetivo: Avaliar a autoeficácia de idosos da zona rural com doenças crônicas antes e após intervenções educativas (interativa ou expositiva).Métodos: Estudo quase-experimental do tipo antes e depois, realizado em setembro de 2016. Aplicaram-se intervenções educativas (interativa ou expositiva) com idosos acompanhados em duas Unidades Básicas de Saúde da zona rural de Senador Pompeu, Ceará. Sorteou-se qual unidade recebeu cada intervenção. Utilizou-se a escala Diabetes Empowerment Scale-Short Form para verificar o efeito das intervenções. Os dados foram analisados por estatística descritiva e testes de diferença. Resultados: Compuseram os grupos 10 (intervenção interativa) e 15 (intervenção expositiva) idosos, com média de idade entre 66,6 e 68,2 anos. Predominaram mulheres, com nível primário e baixo rendimento mensal. A maioria tinha hipertensão arterial (92%) e 24% apresentavam outra doença crônica simultânea. Os escores de autoeficácia nos dois grupos aumentaram depois das intervenções aplicadas (intervenção interativa 0,9 pontos e intervenção expositiva 0,6 pontos), com diferença estatística significante (p=0,008 e p=0,001). Dos itens avaliados, Necessidade de mudança do comportamento e Cuidar de si obtiveram menor e maior aumento das médias entre as avaliações (0,1 e 1,5, respectivamente).Conclusão: As intervenções educativas (interativa ou expositiva) aplicadas aumentaram a autoeficácia de idosos com doenças crônicas. Descritores: Autoeficácia; Educação em Saúde; Idoso; Atenção Primária à Saúde; Doença Crônica.

Objective: To evaluate the self-efficacy of rural older people with chronic diseases before and after educational interventions (interactive or expository). Methods: A quasi-experimental before and after study conducted in September 2016. Educational interventions (interactive or expository) were applied with older people accompanied in two Basic Health Units in the rural area of Senador Pompeu, Ceará. The assignment of intervention to each of the units was defined by lot. The Diabetes Empowerment Scale-Short Form scale was used to verify the effect of interventions. Data were analyzed by descriptive statistics and difference tests.Results: Groups 10 (interactive intervention) and 15 (expository intervention) were composed, with a mean age between 66.6 and 68.2 years.Women with primary level and low monthly income predominated. The majority had hypertension (92%) and 24% had another simultaneous chronic disease. Self-efficacy scores in both groups increased after the applied interventions (interactive intervention 0.9points and expository intervention 0.6 points, respectively), with a statistically significant difference (p=0.008 and p=0.001). Of the items evaluated, Need for behavior change and Taking care of oneself obtained a lower and higher increase in the means between the evaluations (0.1 and 1.5, respectively).Conclusion: The educational interventions (interactive or expository) applied increased the self-efficacy of older people with chronic diseases. Descriptors: Self efficacy; Health Education; Aged; Primary health care; Chronic disease.

Fatores associados a qualidade do sono ruim em universitários de enfermagem de uma universidade privada cearense / Factors associated with poor sleep quality in nursing students from a private university in Ceará

Sleep is essential for the physical, psychological, and social well-being of individuals. Its poor quality/quantity may lead to functional impairment in the performance of social activities and interpersonal relationships. In this context, studies have identified poor sleep quality in university students, especially those in healthcare. Despite the literature pointing out that nursing students do not sleep well, factors related to employment or daily commuting are not unanimous. Thus, the objective of the study is to evaluate the sleep quality of nursing students and its association with socioeconomic characteristics, life habits, academic, and extracurricular activities. This is a cross-sectional, descriptive study with quantitative analysis, carried out with 124 Nursing students from a private Higher Education Institution in Ceará. A questionnaire was used with socioeconomic variables, life-style habits, academic and extracurricular activities, and the Pittsburgh Sleep Quality Index. Descriptive and inferential statistical analyses were performed. The results of this study showed a predominance of poor sleep quality for 73 (59%) students and the presence of sleeping disorders for 38 (31%) of the participants. The variables associated with this result were the daily intercity commute (to-and-fro) to attend an undergraduate class or to have a concomitant job. Meanwhile, the other academic, extracurricular, and lifestyle variables did not have a statistically significant association with sleep quality. Therefore, it is necessary to adopt actions aimed at good sleep hygiene, for better use of the available time for sleep, better academic performance, and quality of life.

O sono é essencial para o bem-estar físico, psíquico e social dos indivíduos. Sua qualidade/quantidade ruim poderá levar a prejuízo funcional no desempenho dos papéis sociais e nas relações interpessoais. Nesse contexto, estudos comprovam uma qualidade do sono ruim em universitários, especialmente os da área da saúde. Apesar da literatura apontar que universitários de enfermagem são maus dormidores, fatores relacionados como vínculo empregatício ou deslocamento intermunicipal diário não são unânimes. Assim, o objetivo do estudo é avaliar a qualidade do sono de estudantes de enfermagem e sua associação com características socioeconômicas, hábitos de vida, atividades acadêmicas e extracurriculares. Trata-se de um estudo transversal, descritivo, com análise quantitativa, realizado com 124 estudantes de Enfermagem de uma Instituição de Ensino Superior privada cearense. Empregou-se questionário com variáveis socioeconômicas, hábitos de vida, atividades acadêmicas e extracurriculares, e o Índice da Qualidade do Sono de Pittsburgh. Foi realizada análise estatística descritiva e inferencial. Os resultados deste estudo demonstraram predominância de qualidade do sono ruim para 73 (59%) estudantes e presença de distúrbios do sono para 38 (31%) dos participantes. As variáveis associadas a esse resultado foram o deslocamento intermunicipal diário (movimento pendular) para cursar a graduação ou possuir vínculo empregatício concomitante. Enquanto, as demais variáveis acadêmicas, extracurriculares e de hábitos de vida não tiveram associação estatisticamente significante com a qualidade do sono. Logo, é necessária a adoção de ações visando a boa higiene do sono, para melhor aproveitamento do período disponível para o sono, melhor desempenho acadêmico e qualidade de vida

Factors associated with older adults' knowledge, attitude and practice on skin cancer prevention / Factores asociados al conocimiento, actitud y práctica de los ancianos sobre la prevención del cáncer de piel / Fatores associados a conhecimento, atitude e prática de idosos sobre prevenção do câncer de pele

ABSTRACT Objectives: to identify factors associated with older adults' knowledge, attitude and practice regarding skin cancer prevention. Methods: this is a cross-sectional study, carried out with 120 older adults from a Basic Health Unit in Quixadá, Ceará, from September to November 2018. Results: individuals aged 60 to 69 years and working were statistically associated with adequate knowledge (p=0.038). Having light skin, eyes and hair was associated with adequate attitude (p=0.030). Having skin problems, such as bleeding wounds, was associated with adequate practice (p=0.016). With regard to inappropriate behavior for skin cancer prevention, there was a statistically significant association between working or having worked under direct exposure to the sun, inadequate knowledge (p=0.036), inadequate attitude (p=0.010) and having incomplete primary education and inadequate practice (p<0.001). Conclusions: sociodemographic and clinical factors influence older adults' knowledge, attitude and practice regarding skin cancer prevention.

RESUMEN Objetivos: identificar factores asociados al conocimiento, actitud y práctica de los ancianos en relación a la prevención del cáncer de piel. Métodos: estudio transversal, realizado con 120 ancianos de una Unidad Básica de Salud de Quixadá, Ceará, de septiembre a noviembre de 2018. Resultados: los individuos de 60 a 69 años y que trabajaban se asociaron estadísticamente con conocimientos adecuados (p=0,038). Tener piel, ojos y cabello claros se asoció con una actitud adecuada (p=0,030). Tener problemas en la piel, como heridas sangrantes, se asoció con una práctica adecuada (p=0,016). Sobre conductas inapropiadas para la prevención del cáncer de piel, hubo asociación estadísticamente significativa entre trabajar o haber trabajado bajo exposición directa al sol, conocimientos inadecuados (p=0,036), actitud inadecuada (p=0,010), tener instrucción primaria incompleta y práctica inadecuada (p<0,001). Conclusiones: los factores sociodemográficos y clínicos influyen en el conocimiento, la actitud y la práctica de los ancianos respecto a la prevención del cáncer de piel.

RESUMO Objetivos: identificar fatores associados a conhecimento, atitude e prática de idosos sobre a prevenção do câncer de pele. Métodos: estudo transversal, realizado com 120 idosos de uma Unidade Básica de Saúde em Quixadá, Ceará, de setembro a novembro de 2018. Resultados: indivíduos na faixa etária de 60 a 69 anos e trabalhando estiveram associados estatisticamente ao conhecimento adequado (p=0,038). O fato de ter pele, olhos e cabelos claros estava associado à atitude adequada (p=0,030). Ter problemas de pele, do tipo ferida sangrante, estava associado à prática adequada (p=0,016). Acerca das condutas inadequadas para a prevenção do câncer de pele, observou-se associação estatisticamente significante entre trabalhar ou já ter trabalhado sob exposição direta ao sol, conhecimento inadequado (p=0,036), atitude inadequada (p=0,010), ter o ensino fundamental incompleto e prática inadequada (p<0,001). Conclusões: fatores sociodemográficos e clínicos influenciam no conhecimento, atitude e prática de idosos sobre a prevenção do câncer de pele.

Health literacy and adherence to the pharmacological treatment by people with arterial hypertension / Alfabetización en salud y adhesión al tratamiento farmacológico de personas con hipertensión arterial / Letramento em saúde e adesão ao tratamento farmacológico de pessoas com hipertensão arterial

ABSTRACT Objective: To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension. Methods: Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests. Results: People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence. Conclusions: A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.

RESUMEN Objetivo: Analizar relación entre alfabetización en salud y adhesión al tratamiento farmacológico de brasileños con hipertensión arterial. Métodos: Estudio transversal, desarrollado con 234 participantes, que respondieron una encuesta online de caracterización sociodemográfica, clínica, evaluación de la alfabetización en salud y de la adhesión al tratamiento farmacológico. Los datos fueron analizados con estadística descriptiva y testes de diferencia y correlación. Resultados: Personas con postgrado, que trabajabany no tabaquistas obtuvieron mejores resultados de alfabetización en salud. Ancianos yjubilados/pensionistas presentaron mejor adhesión al tratamiento medicamentoso. Hubo correlación entre la dimensión numérica (rs = 0,189; p = 0,004) yel resultado global de alfabetización en salud (rs = 0,170; p = 0,009) con la adhesión. Conclusiones: Mejor comprensión numérica y global de alfabetización en salud estuvieron relacionados a mejores resultados de adhesión al tratamiento medicamentoso de la hipertensión arterial.

RESUMO Objetivo: Analisar a associação entre o letramento em saúde e a adesão ao tratamento farmacológico de brasileiros com hipertensão arterial. Métodos: Estudo transversal, desenvolvido com 234 participantes, que responderam um questionário on-line de caracterização sociodemográfica, clínica, avaliação do letramento em saúde e da adesão ao tratamento farmacológico.Os dados foram analisados com estatística descritiva e testes de diferença e correlação. Resultados: Pessoas com pós-graduação, que trabalhavam e não tabagistas obtiveram melhores resultados de letramento em saúde. Idosos e aposentados/pensionistas apresentaram melhor adesão ao tratamento medicamentoso. Houve correlação entre a dimensão numérica (rs=0,189; p=0,004) e o resultado global de letramento em saúde (rs = 0,170; p=0,009) com a adesão. Conclusões: Melhor compreensão numérica e global de letramento em saúde estiveram associados a melhores resultados de adesão ao tratamento medicamentoso da hipertensão arterial.

Fatores associados a qualidade do sono ruim em universitários de enfermagem de uma universidade privada cearense / Factors associated with poor sleep quality in nursing students from a private university in Ceará

O sono é essencial para o bem-estar físico, psíquico e social dos indivíduos. Sua qualidade/quantidade ruim poderá levar a prejuízo funcional no desempenho dos papéis sociais e nas relações interpessoais. Nesse contexto, estudos comprovam uma qualidade do sono ruim em universitários, especialmente os da área da saúde. Apesar da literatura apontar que universitários de enfermagem são maus dormidores, fatores relacionados como vínculo empregatício ou deslocamento intermunicipal diário não são unânimes. Assim, o objetivo do estudo é avaliar a qualidade do sono de estudantes de enfermagem e sua associação com características socioeconômicas, hábitos de vida, atividades acadêmicas e extracurriculares. Trata-se de um estudo transversal, descritivo, com análise quantitativa, realizado com 124 estudantes de Enfermagem de uma Instituição de Ensino Superior privada cearense. Empregou-se questionário com variáveis socioeconômicas, hábitos de vida, atividades acadêmicas e extracurriculares, e o Índice da Qualidade do Sono de Pittsburgh. Foi realizada análise estatística descritiva e inferencial. Os resultados deste estudo demonstraram predominância de qualidade do sono ruim para 73 (59%) estudantes e presença de distúrbios do sono para 38 (31%) dos participantes. As variáveis associadas a esse resultado foram o deslocamento intermunicipal diário (movimento pendular) para cursar a graduação ou possuir vínculo empregatício concomitante. Enquanto, as demais variáveis acadêmicas, extracurriculares e de hábitos de vida não tiveram associação estatisticamente significante com a qualidade do sono. Logo, é necessária a adoção de ações visando a boa higiene do sono, para melhor aproveitamento do período disponível para o sono, melhor desempenho acadêmico e qualidade de vida.

Sleep is essential for the physical, psychological, and social well-being of individuals. Its poor quality/quantity may lead to functional impairment in the performance of social activities and interpersonal relationships. In this context, studies have identified poor sleep quality in university students, especially those in healthcare. Despite the literature pointing out that nursing students do not sleep well, factors related to employment or daily commuting are not unanimous. Thus, the objective of the study is to evaluate the sleep quality of nursing students and its association with socioeconomic characteristics, life habits, academic, and extracurricular activities. This is a cross-sectional, descriptive study with quantitative analysis, carried out with 124 Nursing students from a private Higher Education Institution in Ceará. A questionnaire was used with socioeconomic variables, life-style habits, academic and extracurricular activities, and the Pittsburgh Sleep Quality Index. Descriptive and inferential statistical analyses were performed. The results of this study showed a predominance of poor sleep quality for 73 (59%) students and the presence of sleeping disorders for 38 (31%) of the participants. The variables associated with this result were the daily intercity commute (to-and-fro) to attend an undergraduate class or to have a concomitant job. Meanwhile, the other academic, extracurricular, and lifestyle variables did not have a statistically significant association with sleep quality. Therefore, it is necessary to adopt actions aimed at good sleep hygiene, for better use of the available time for sleep, better academic performance, and quality of life.

Qualidade de vida no trabalho do agente penitenciário cearense / Quality of life at work of the prison agent in Ceará

Objetivo:avaliar a Qualidade de Vida no Trabalho dos agentes penitenciários cearenses. Metodologia: estudo transversal e descritivo, com análise quantitativa. A coleta ocorreu nos meses de agosto e setembro de 2018, utilizando-se um questionário eletrônico com dados sociodemográficos e o instrumento Quality of Working Life Questionnaire(QWQL-Bref). A amostragem ocorreu por bola de neve e os dados foram analisados por estatística descritiva. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa do Centro Universitário Católica de Quixadá, sob parecer 2.719.401. Resultados:participaram 57 agentes penitenciários, predominando homens, com faixa etária de 31 a 43 anos de idade, casados, com ensino superior completo, que atuam na profissão de um a cinco anos, com jornada trabalhista de 40 a 48 horas semanais. A qualidade de vida no trabalho foi classificada como neutra, sendo o domínio pessoal o único com média satisfatória e o domínio profissional com menor média neutra obtida. Conclusão:a qualidade de vida no trabalho foi considerada neutra, mas os fatores de alerta para a diminuição da qualidade de vida no trabalho não podem ser subestimados. Destaca-se a importância de se promover ações para melhorar as condições de trabalho e suas implicações na saúde física e mental destes indivíduos.

Objective: to evaluate the Quality of Life at Work of prison agents in Ceará. Methodology:cross-sectional and descriptive study, with a quantitative approach. The data collection took place in August and September 2018, using an electronic questionnaire with sociodemographic variables and the Quality of Life at Work Questionnaire (QWQL-Bref). The sampling considered the snowball technique and the data were analyzed using descriptive statistics. The research was approved by the Research Ethics Committee from the Centro Universitário Católico de Quixadá, under protocol number 2.719.401. Results: 57 prison officers participated, predominantly men, aged between 31 and 43 years, married, with complete higher education, who worked in the profession from one to five years, with 40 to 48 hours of work per week. The quality of life at work was classified as neutral, with the personal domain being the only one with a satisfactory mean and the professional domain with the lowest neutral averageobtained. Conclusion: the quality of life at work was considered neutral, but the warning signals for the decrease in the quality of life at work cannot be underestimated. The importance of promoting actions to improve working conditions and their implications for the physical and mental health of these individuals is highlighte

Clinical factors predicting risk for aspiration and respiratory aspiration among patients with Stroke.

OBJECTIVE: to investigate the association of risk factors with the Risk for aspiration nursing diagnosis and respiratory aspiration. METHOD: cross-sectional study assessing 105 patients with stroke. The instrument used to collect data addressing sociodemographic information, clinical variables and risk factors for Risk for aspiration. The clinical judgments of three expert RNs were used to establish the diagnosis. The relationship between variables and strength of association using Odds Ratio (OR) was verified both in regard to Risk for aspiration and respiratory aspiration. RESULTS: risk for aspiration was present in 34.3% of the patients and aspiration in 30.5%. The following stood out among the risk factors: Dysphagia, Impaired or absent gag reflex, Neurological disorders, and Impaired physical mobility, all of which were statistically associated with Risk for aspiration. Note that patients who develop such a diagnosis were seven times more likely to develop respiratory aspiration. CONCLUSION: dysphagia, Impaired or absent gag reflex were the best predictors both for Risk for aspiration and respiratory aspiration.

Sofrimento emocional relacionado ao diabetes mellitus tipo 2: análise na atenção primária à saúde / Emotional suffering related to type 2 diabetes mellitus: analysis in primary health care

Objective:To analyze the emotional suffering related to type 2 Diabetes Mellitus in people assisted in primary health care. Method:Cross-sectional, quantitative study conducted in two basic health units in Ceará. The Brazilian version of the Problem Areas in Diabetes Scale was used for data collection and assessment of emotional distress. Data were collected from a primary source through home visits. Descriptive and analytical statistics were performed. The ethical principles of research with human beings were respected. Results:One hundred and thirteen (113) people with type 2 Diabetes Mellitus participated in the research. Elderly, mixed race/black women, with incomplete elementary education, sedentary, non-smokers and non-alcoholics predominated. Most participants had a high degree of emotional distress. The concern with future complications and the fear of living with the disease were considered relevant problems by the participants. There was a statistically significant association between the variables sex and place of residence with a high degree of mental suffering. Conclusion:Primary care professionals need to plan nursing care aimed at emotional suffering related to type 2 Diabetes Mellitus, especially among female people who live in rural areas.

Objetivo: Analisar o sofrimento emocional relacionado ao Diabetes Mellitus tipo 2, em pessoas atendidas na atenção primária à saúde. Método: Estudo transversal, quantitativo, realizado em duas unidades básicas de saúde cearenses. Para coleta de dados, utilizou-se da Escala Brazilian version of the Problem Areas in Diabetes para avaliar o sofrimento emocional. Os dados foram coletados com fonte primária, por visitas domiciliares. Realizou-se estatística descritiva e analítica. Os princípios éticos de pesquisa com seres humanos foram respeitados. Resultados: Participaram da pesquisa 113 pessoas com Diabetes Mellitus tipo 2. Predominaram idosas, pardas/ negras, com nível de escolaridade de ensino fundamental incompleto, sedentárias, não tabagistas e não etilistas. Em maioria, os participantes apresentaram alto grau de sofrimento emocional. A preocupação com complicações futuras e o medo de conviver com a doença foram considerados problemas relevantes pelos participantes. Houve associação estatisticamente significante das variáveis sexo e local de residência com alto grau de sofrimento mental. Conclusão: Os profissionais da atenção primária precisam planejar a assistência de enfermagem voltada para o sofrimento emocional relacionado ao Diabetes Mellitus tipo 2, especialmente entre pessoas do sexo feminino e que residem em áreas rurais.

Fatores de risco modificáveis para doenças crônicas não transmissíveis entre estudantes universitários / Modifiable risk factors for chronic non-communicable diseases among university students

Objetivo: identificar fatores de risco modificáveis para doenças crônicas não transmissíveis entre estudantes universitários. Métodos: estudo transversal, realizado em Centro Universitário privado, no sertão central cearense, com 329 estudantes, entrevistados por meio de questionário e analisados por estatística descritiva e inferencial. Resultados: predominaram estudantes com mediana de 21 anos de idade, sexo feminino (74,5%), solteiros (87,8%) e renda superior a três salários mínimos. Consumo de alimentos protetores considerado insuficiente e de alimentos prejudiciais, adequado. Não praticavam atividade física (62,2%), baixo consumo de tabaco (1,3%) e alta prevalência de etilismo (37,8%). Práticas de atividades físicas, etilismo e consumo de legumes/verduras estiveram associados significativamente com dados sociodemográficos e de saúde. Conclusão: foram identificados fatores de risco modificáveis para doenças não transmissíveis, tornando necessária articulação entre o setor saúde e a universidade, na implantação de estratégias de promoção à saúde em instituições de ensino. (AU)

Burden and modifications in life from the perspective of caregivers for patients after stroke.

OBJECTIVE: to analyze the impact that caring has on a member of the family caring for a patient after a cerebrovascular accident, correlating life modifications and mental suffering with the perceived burden. METHOD: a cross-sectional, quantitative study, undertaken in January-April 2010 in Fortaleza, Ceará, Brazil. RESULT: 61 individuals were investigated, monitored by three hospitals' Home Care Program. Data collection was through interviews for identifying life changes, and through the application of three scales for investigating perceived burden, mental state and mental suffering. Respectively these were the Caregiver Burden Scale (CBS), the Mini-Mental State Examination (MMSE) and the Self Reported Questionnaire (SRQ). The majority of the carers were female, married, and the children of the stroke patients. The average age was 48.2 years (±12.4). The most-cited life modifications referred to the daily routine, to leisure activities, and to exhaustion or tiredness. Regarding burden, the dimensions of General tension, Isolation and Disappointment stood out. It was ascertained that overload was more severe when the carer presented more symptoms of psychological distress, in the absence of a secondary carer, and when the principal carers reported perceiving changes in their bodies and health. CONCLUSION: an association between burden and the carer's mental state was not observed. Understanding the care, through analysis of the burden and of the knowledge of the biopsychosocial situation will provide support for the nurse's work in reducing the overload for family caregivers.