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RESUMEN Introducción: el cáncer cervical representa un grave problema de salud pública a pesar de ser altamente prevenible. Objetivo: determinar las características clínicas y epidemiológicas de la participación de las mujeres del área de influencia de un Hospital Público en la prevención del cáncer de cuello uterino entre los meses de enero a diciembre de los años 2020 al 2021. Metodología: diseño no experimental de corte transversal tipo descriptivo, con enfoque cuantitativo. Se incluyó el total de mujeres participantes de la prevención de cáncer cervical en el área de influencia del Hospital Público. Se utilizaron datos secundarios que fueron cargados en una planilla elaborada previamente. Resultados: el 61 % de las mujeres estaban en edad de riesgo, 83 % no estaban embarazadas y 17 % si, 53 % tiene antecedente de PAP y 47 %, no, 86 % tuvo resultado negativo para lesión, 9 % inflamatorio y 4 % positivo. Entre los resultados positivos el preponderante fue el de ASCUS con un 47 %. Se concluye que la mayoría de las mujeres tuvieron un resultado de PAP negativo. Entre las mujeres con resultados positivos se tuvo preponderancia de diagnósticos de ASCUS y en segundo lugar CIN I LSIL. Conclusión: las características que se encontraron significativamente asociadas al resultado de PAP fueron: formar parte del grupo de edad de riesgo y presencia de embarazo. Se sugiere seguir haciendo hincapié en la prevención y seguimiento, indagar en las edades de riesgo e incluir otras variables de interés en futuros estudios.
ABSTRACT Introduction: cervical cancer represents a serious public health problem despite being highly preventable. Objective: to determine the clinical and epidemiological characteristics of the participation of women in the area of influence of a Public Hospital in the prevention of cervical cancer between the months of January to December of the years 2020 to 2021. Methodology: non-experimental cross-sectional descriptive design, with a quantitative approach. The total number of women participating in the prevention of cervical cancer in the area of influence of the Public Hospital was included. Secondary data were used that were loaded into a previously prepared form. Results: 61 % of the women were of 13 years old at risk, 83 % were not pregnant and 17 % were pregnant, 53 % had a history of PAP and 47 % did not, 86 % had a negative result for lesion, 9 % inflammatory and 4 % positive. Among the positive results, the predominant one was ASCUS with 47 %. The majority women had a negative PAP result. As a conclusion among women with positive results, there was a predominance of ASCUS diagnoses and in second place CIN I LSIL. Conclusion: the features that were found to be significantly associated with the PAP result were: being part of the age group at risk and presence of pregnancy. It is suggested to continue emphasizing prevention and follow-up, to investigate the ages at risk and to include other variables of interest in future studies.
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Background: Community participation in health programs helps drive collaborations between the formal health structures and informal health system actors in promoting health at the community level. This paper provides new information on the extent of community participation in the planning and implementation of community-based health programs in Nigeria as a trajectory for strengthening the health system. Methods: This was a qualitative study. Data was collected from three located in different geographic zones of Nigeria. Two local governments (rural and urban) with evidence of health programs were purposively selected in each state. Data were collected through in-depth interviews and focus group discussions. The data was transcribed, coded manually and analysed thematically. Results: Several health programs were identified in the community. It was found that while community leaders are hardly involved in conceptualizing and planning health programs, however, they participate in program implementation by mobilizing community resources and encouraging members to take advantage of available health activities. Our findings also showed increased benefits of the involvement of the informal health workers in the health system. Conclusions: Community participation and involvement in health as part of community health system (CHS) activities has led to better and well-improved services, increased willingness to access immunization services. Communities are readily available to contribute to health activities, but they should be involved in the initiation and planning of health activities for ownership and full participation. This would improve health outcomes and contribute to strengthening the community health system.
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RESUMEN El fortalecimiento comunitario a partir de estrategias participativas es un proceso que organiza, promueve y genera transformaciones para el mejoramiento de la gestión del recurso hídrico en zonas rurales. Objetivo: Evidenciar las estrategias de fortalecimiento comunitario bajo los principios de Apropiación Social del Conocimiento, con el fin de mejorar la gestión del recurso hídrico en una zona rural específica del departamento del Cauca. Metodología: Se llevó a cabo un estudio exploratorio de investigación cualitativa a través de la implementación de estrategias de fortalecimiento comunitario rural para la gestión del recurso hídrico, orientada bajo los cinco principios de la Política Nacional de Apropiación Social del Conocimiento. Resultados: El reconocimiento de contextos mediante el trabajo con grupos focales y cartografía social, evidenció problemáticas ambientales y sociales, resaltando el conflicto intercultural entre poblaciones indígenas y campesinas. Las herramientas de participación utilizadas permitieron la creación conjunta de una agenda de acción para la transformación a nivel de microcuenca, sistema de acueducto, escuelas y hogares. Conclusión: La participación comunitaria es un componente esencial que permitió una priorización efectiva de los desafíos asociados al recurso hídrico. Además, facilitó la planificación de acciones transformadoras y la implementación de soluciones sostenibles mediante la construcción colectiva del conocimiento. Estos hallazgos resaltan la importancia de integrar la participación comunitaria y los principios de Apropiación Social del Conocimiento para abordar de manera integral y efectiva los retos en la gestión del agua en entornos rurales.
ABSTRACT Community strengthening based on participatory strategies is a process that organizes, promotes, and generates transformations to improve water resource management in rural areas. Objective: Show the community strengthening strategies based on the principles of social appropriation of knowledge for the improvement of water resource management in a specific rural area of the department of Cauca. Methodology: An exploratory qualitative research study was carried out by implementing rural community strengthening strategies for water resource management, oriented under the five principles of the National Policy for Social Appropriation of Knowledge. Results: The survey of contexts through work with focus groups and social mapping evidenced environmental and social problems, highlighting the intercultural conflict between indigenous and peasant populations. The participation strategies used allowed the co-creation of an action agenda for transformation at the watershed, aqueduct system, school, and household levels. Conclusion: Community participation is an essential component that allows effective prioritization of the challenges associated with water resources. In addition, it facilitated the planning of transformative actions and the implementation of sustainable solutions through the collective construction of knowledge. These findings highlight the importance of integrating community participation and the principles of Social Appropriation of Knowledge to comprehensively and effectively address water management challenges in rural territories.
RESUMO O fortalecimento da comunidade com base em estratégias participativas é um processo que organiza, promove e gera transformações para a melhoria da gestão de recursos hídricos em áreas rurais. Objetivo: Demonstrar estratégias de fortalecimento comunitário sob os princípios da Apropriação Social do Conhecimento, a fim de melhorar a gestão dos recursos hídricos em uma área rural específica do departamento de Cauca. Metodologia: Foi realizado um estudo exploratório de pesquisa qualitativa por meio da implementação de estratégias de fortalecimento comunitário rural para a gestão de recursos hídricos, orientadas pelos cinco princípios da Política Nacional de Apropriação Social do Conhecimento. Resultados: O reconhecimento de contextos por meio do trabalho com grupos focais e mapeamento social revelou problemas ambientais e sociais, destacando o conflito intercultural entre populações indígenas e camponesas. As ferramentas participativas utilizadas permitiram a criação conjunta de uma agenda de ação para transformação em nível de microbacia hidrográfica, sistema de aqueduto, escola e familia. Conclusão: a participação da comunidade é um componente essencial que permitiu a priorização efetiva dos desafios associados aos recursos hídricos. Ela também facilitou o planejamento de ações transformadoras e a implementação de soluções sustentáveis por meio da construção de conhecimento coletivo. Essas descobertas destacam a importância de integrar a participação da comunidade e os princípios da Apropriação Social do Conhecimento para abordar de forma abrangente e eficaz os desafios da gestão da água em ambientes rurais.
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Resumo Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.
Abstract This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.
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Resumo Esta revisão narrativa tem por objetivo analisar a literatura no âmbito da Saúde Coletiva no intento de reconhecer o que se tem discutido em Educação Popular em Saúde (EPS) entre 2019 e 2022. Após busca, 59 artigos foram selecionados, analisados criticamente e separados em seis categorias-síntese: as práticas de educação popular como promotoras de uma visão participativa da saúde; educação popular e a valorização dos saberes e práticas da cultura popular local; a educação popular em saúde como estratégia de apoio à reconstrução social ante aos retrocessos nas políticas públicas; a importância da articulação nacional em educação popular como resposta à sua desvalorização; a educação popular como projeto libertador pensando a formação democrática e luta contra violências institucionais e estruturais; educação popular no processo de formação universitária em saúde. Pôde-se obter importantes resultados que elucidam a importância da EPS no contexto do Sistema Único de Saúde e na formação acadêmica de profissionais da saúde, favorecendo o respeito aos saberes ancestrais e a horizontalidade do cuidado. Ainda, reafirma-se a necessidade de articulação nacional e dialogada com os movimentos populares para o avanço de uma agenda emancipadora e dignificante da saúde no Brasil.
Abstract This narrative review aims to analyze the literature on Collective Health to recognize what has been discussed in Popular Health Education (PHE) from 2019 to 2022. Fifty-nine articles were selected, critically analyzed, and separated into six summary categories: popular education practices as promoters of a participatory vision of health; popular education and the valorization of local popular culture knowledge and practices; popular health education as a strategy to support social reconstruction in the face of setbacks in public policies; the importance of national articulation in popular education as a response to its devaluation; popular education as a liberating project thinking about the democratic formation and the fight against institutional and structural violence; popular education in the university health training process. We achieved significant results that elucidate the importance of PHE within the Unified Health System and the academic education of health professionals, fostering respect for ancestral knowledge and care horizontality. We also reaffirm the need for national articulation and dialogue with grassroots movements to advance Brazil's emancipatory and dignifying health agenda.
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Resumo O artigo discute questões sobre o futuro da humanidade ante as ameaças que rondam a saúde das populações, cujo impacto vem se exacerbando no curso das desigualdades em todas as partes do mundo, pari passu o desenvolvimento global no modelo hegemonizado a partir do século passado. A pandemia de COVID-19 foi tomada como um caso que bem ilustra essa dessintonia entre desenvolvimento e desigualdades. Formulam-se perguntas a serem postas em debate sobre a construção do futuro da sociedade mundial, com base na acepção sobre o caráter evolucional da vida no planeta vis-à-vis os males que acometem grandes contingentes populacionais e representam poderosos riscos para esse processo evolutivo. São indagações que apontam para a discussão em torno da participação social na definição e no controle das políticas públicas, em contrapartida à hegemonia dos interesses privados na formulação e execução dessas políticas, tanto nos cenários de cada país como no contexto internacional.
Abstract This article discusses questions concerning the future of humanity in the face of threats to the health of populations, whose impact has been exacerbated in the course of inequalities in all parts of the world, pari passu with global development in the hegemonized model since last century. The COVID-19 pandemic is a good example that illustrates this dissonance between development and inequalities. Questions were formulated to be debated about the construction of the future of world society, based on the understanding of the evolutionary character of life on the planet vis-à-vis the evils that affect large contingents of the population and represent powerful risks for this evolutionary process. These questions call attention to the discussion around social participation in the definition and control of public policies, as opposed to the hegemony of private interests in the formulation and execution of these policies, both in the scenarios of each country and in the international context.
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Resumen El objetivo general de la investigación fue establecer la relación entre las prácticas de crianza y la participación ciudadana en adolescentes, mediadas por el apoyo parental a la autonomía y las habilidades para la vida. Investigaciones previas señalan que el apoyo parental hacia la autonomía se relaciona con el desarrollo de comportamientos políticos en los adolescentes y que las habilidades para la vida pueden predecir la participación cívica. En Cundinamarca se han realizado estudios de la participación ciudadana en la juventud, pero no indagan sobre aspectos familiares, como las prácticas de crianza. Se planteó un estudio mixto, mediante el modelamiento de ecuaciones estructurales y entrevistas en profundidad. Participaron 298 padres de familia y sus hijos adolescentes, habitantes de tres municipios de Cundinamarca. Los resultados muestran que existe una relación significativa entre el fomento de las habilidades para la vida (comunicación asertiva, pensamiento crítico y empatía) y las prácticas de crianza (comunicación), con una mayor participación ciudadana adolescente, especialmente en acciones de impacto comunitarias. Lo anterior permite señalar la relevancia de las variables familiares en el estudio de los comportamientos cívicos.
Abstract The general objective of the article is to establish the relationship between parenting practices and citizen participation in adolescents, mediated by parental support for autonomy and life skills. Previous research indicates that parental support for autonomy is related to the development of political behaviors, and that life skills may be predictors of civic participation. In Cundinamarca, studies have been carried out on citizen participation in youth, however, these works inquired about institutions that encouraged such participation but did not address parenting practices. A mixed study was approached, using structural equation modeling and in-depth interviews. A total of 298 parents and their adolescent children, residents of three municipalities in the department of Cundinamarca, participated in the study. The results show that there is a significant relationship between parenting practices (communication) and the promotion of life skills (assertive communication, critical thinking and empathy), with greater political participation of adolescents, especially in community advocacy actions. The above allows us to point out the relevance of family variables in the study of civic behaviors.
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Resumen (analítico) Este estudio buscó conocer los significados que construyen profesionales del programa Mi Abogado (Chile) sobre el vínculo y la participación infantil. Bajo un diseño cualitativo exploratorio, se realizaron entrevistas semiestructuradas y se aplicó un análisis de contenido. Los participantes señalan que se requiere conocer al niño o adolescente, reconocer su singularidad y su historia de vida. A su vez, es necesario reconstruir la confianza en el mundo adulto, para construir un vínculo significativo como base de la participación infantil. Reconocer la singularidad y reconstruir la confianza permite representarles mejor y fortalecer su agencia, facilitando su participación en los procesos que les afectan directamente. Se sugiere conocer cómo los nuevos programas construyen significados en torno a los derechos en este contexto que busca superar una perspectiva tutelar.
Abstract (analytical) This study aimed to understand the meanings developed by professional staff in the Mi Abogado Program (Chile). Using a qualitative exploratory design, semi-structured interviews were conducted with professionals and content analysis was applied. Participants highlighted a number of essential factors in their work, including that it was necessary to get to know the children and recognize their unique circumstances and life histories. At the same time, they stated that it was necessary to rebuild their trust in adults in order to form a significant relationship and enable child participation. Identification of their unique circumstances, generating trust and forming significant relationships lead to better legal representation of these children, strengthen agency and facilitate their participation in the processes that directly affect them. The authors conclude by the article by recommending further examination of how new programs are building meanings around children's rights in a context that seeks to overcome existing power imbalances.
Resumo (analítico) Este estudo buscou compreender os significados construídos pelos profissionais do Programa Mi Abogado (Chile) sobre vínculo e participação infantil. Sob um delineamento exploratório qualitativo, foram realizadas entrevistas semiestruturadas com profissionais e aplicada a análise de conteúdo das entrevistas. Os participantes destacam que é preciso conhecer à criança, reconhecer sua singularidade e sua história de vida. Ao mesmo tempo, é preciso reconstruir a confiança nos adultos, a fim de construir um vínculo significativo e possibilitar a participação infantil. Singularidade, confiança e vínculo significativo permitem uma melhor representação, fortalecem sua agência e facilitam a participação nos processos que os afetam diretamente. É relevante explorar como novos programas estão construindo significados em torno dos direitos da criança neste contexto que busca superar o enfoque tutelar.
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No cenário pandêmico, o Sistema Único de Saúde precisou reinventar seus processos de trabalho, estabelecer novos fluxos de atendimento e fortalecer suas redes de atenção para prevenir e reduzir o contágio do vírus. Este estudo visa avaliar, do ponto de vista dos usuários, os desafios da Atenção Primária à Saúde em João Pessoa, Paraíba, no controle do coronavírus. Trata-se de uma pesquisa transversal descritiva, com abordagem qualiquantitativa, que utilizou questionários elaborados no aplicativo Google Forms® e analisou os resultados por meio da estatística descritiva simples. Diante disso, foram selecionados quarenta usuários da Unidade Básica de Saúde, escolhidos durante as visitas dos pesquisadores à unidade localizada no bairro Cristo Redentor, em João Pessoa, entre março de 2020 e março de 2022. Ao serem questionados acerca da qualidade do preparo assistencial da unidade em relação ao atendimento dos casos não suspeitos, alguns usuários, ainda que uma parcela minoritária, fizeram uma avaliação negativa, uma vez que sentiram falta do cuidado assistencial. Além disso, conforme os relatos dos usuários, foram escassas as ações das equipes na busca ativa de sintomas respiratórios em grupos de risco. No tocante à comunicação da unidade com a comunidade durante a pandemia, foram relatadas dificuldades em contatar o posto, o que traz à tona a importância do agente comunitário de saúde e abre uma discussão sobre telessaúde, além de destacar a inviabilização da longitudinalidade e integralidade do cuidado durante esse período. Diante da crise sanitária global, nota-se que o confronto à pandemia pressupôs uma reestruturação da rede assistencial, na qual o verdadeiro desafio da Atenção Primária foi aprofundar seus atributos.
In the pandemic scenario, the Unified Health System had to reinvent its work processes, establishing new service flows and strengthening its care networks to prevent and reduce the virus spread. This study evaluates, from the user perspective, the challenges faced by Primary Health Care in João Pessoa, Paraíba, in controlling the coronavirus. A descriptive, qualitative-quantitative cross-sectional research was conducted by applying questionnaires prepared using Google Forms®. Results were analyzed using simple descriptive statistics. A total of 40 Basic Health Unit users were selected during researchers' visits to the Cristo Redentor neighborhood unit between March 2020 and March 2022. When asked about the unit's care quality regarding non-suspect cases, some users made a negative evaluation, since the attention dispended felt lacking. Moreover, according to the participants, the teams seldomly actively searched for respiratory symptoms in risk groups. Regarding the unit's communication with the community during the pandemic, users reported difficulties in contacting the unit, which brings up the importance of community health agents and opens the discussion about telemedicine, as well as emphasizes the unfeasibility of care longitudinality and comprehensiveness during this period. Faced with a global health crisis, combating the pandemic required restructuring the care network, in which the real challenge of Primary Care was to further its attributes.
En el escenario de la pandemia, el Sistema Único de Salud necesitó reinventar sus procesos de trabajo, establecer nuevos flujos de servicios y fortalecer sus redes de atención para prevenir y mitigar la propagación del virus. Este estudio tiene como objetivo evaluar, desde el punto de vista de los usuarios, los desafíos de la atención primaria de salud en João Pessoa, Paraíba (Brasil), en el control del coronavirus. Se trata de una investigación descriptiva de corte transversal, con enfoque cualicuantitativo, que utilizó cuestionarios elaborados en la aplicación Google Forms y analizó los resultados mediante estadística descriptiva simple. Así, fueron seleccionados cuarenta usuarios de la Unidad Básica de Salud, elegidos durante las visitas de los investigadores a la unidad ubicada en el barrio Cristo Redentor, en João Pessoa, entre marzo de 2020 y marzo de 2022. Se evidenció una evaluación negativa, aunque minoritaria, al interrogatorio acerca de la calidad de la preparación asistencial de la unidad con relación a la atención de casos no sospechosos, ya que sintieron falta de atención. Además, según los reportes de los usuarios, hubo pocos informes de equipos que buscaran activamente síntomas respiratorios en grupos de riesgo. Respecto a la comunicación de la unidad con la comunidad durante la pandemia, se informaron dificultades para contactar a la unidad, lo que resalta la importancia del agente comunitario de salud y abre la discusión sobre la telesalud, además de poner de relieve la inviabilidad de la longitudinalidad e integralidad de la atención durante este período. Frente a la crisis sanitaria global, se constata que enfrentar la pandemia requirió una reestructuración de la red de atención, en la que el verdadero desafío de la atención primaria era profundizar sus atributos.
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COVID-19ABSTRACT
Objective: To examine the correlation between the Brazilian Active Aging Index (AAI-Brazil) and the Human Development Index (HDI) at both national and regional levels. Methods: Based on the original AAI developed by the United Nations Economic Commission for Europe in response to the World Health Organization's program to promote more active and healthy aging, we calculated the total and domain-specific (AAI-independence, AAIemployment, AAI-capacity, and AAI-participation) scores of the AAI-Brazil for Brazil and its regions. Data were obtained from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and analyzed in relation to the overall HDI and its indicators (HDI-education, HDI-income, and HDI-longevity) using linear regression. Statistical significance was set at p < 0.05. Results: The overall AAI-Brazil score was 34%, with domain-specific scores of 57% for independence, 39% for employment, 14% for capacity 14%, and 9% participation. The CentralWest region had the highest score (36%), followed by the South and Southeast (both 35%). The North and Northeast regions had the lowest overall scores (34% and 32%, respectively), as well as the lowest scores across all domains. A positive and significant relationship was found between the AAI-Brazil and total HDI (p = 0.029), HDI-education (p = 0.011), and HDI-income (p = 0.035); as well as between AAI-capacity and total HDI (p = 0.004), HDIeducation (p = 0.016), HDI-income (p = 0.008), and HDI-longevity (p = 0.003). Conclusion: Regions with higher AAI-Brazil scores were associated with higher HDI levels. This finding suggests that human development disparities affect the healthy and active aging of the Brazilian population. (AU)
Objetivos: Relacionar o Índice de Envelhecimento Ativo no Brasil (IEABrasil) total e por módulos, do país e das suas regiões com o Índice de Desenvolvimento Humano (IDH). Metodologia: A partir do Active Ageing Index que foi desenvolvido pela Comissão Econômica das Nações Unidas para a Europa em resposta ao programa da Organização Mundial da Saúde que visa estimular um envelhecimento mais ativo e saudável, foi calculado o IEABrasil total e por módulos (Independência, Emprego, Capacidade e Participação) para o país e cada região. Foram utilizados os dados do Estudo Longitudinal da Saúde dos Idosos do Brasil, e relacionados com o IDH (total, educação, renda e longevidade), através da Regressão Linear, assumindo p<0,05 como estatisticamente significativo. Resultados: Obteve-se IEABrasil total 34%, IEA-Independência 57%, IEA-Emprego 39%, IEA-Capacidade 14% e IEA-Participação 9%. A Região Centro-Oeste pontuou 36%, seguida pelas Regiões Sul e Sudeste, ambas com 35%, e as Regiões Norte e Nordeste ficaram com 34% e 32%, respectivamente. As Regiões Norte e Nordeste também apresentaram piores índices em todos os módulos. Na análise do IEABrasil de cada região com o IDH correspondentes, identificamos relação positiva e significativa entre IEABrasil e IDH total (p=0,029), IDH educação (p=0,011) e IDH renda (p=0,035); IEA-Capacidade com IDH total (p=0,004), IDH educação (p=0,016), IDH renda (p=0,008) e IDH longevidade (p=0,003). Conclusão: As regiões com índices mais elevados de IEABrasil apresentaram maiores níveis de IDH. Os resultados do IEABrasil sugeriram que as desigualdades de desenvolvimento humano afetam o envelhecimento ativo dos brasileiros. (AU)
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Humans , Aged , Aged, 80 and over , Healthy Aging , Human Development , Aged , Aging , Public Health , Social ParticipationABSTRACT
La unión de la teoría y la práctica es crucial para una enseñanza equitativa, además se requiere de estrategias flexibles y efectivas para asegurar la inclusión. El objetivo de este artículo fue proponer estrategias para la participación de estudiantes con discapacidad en las clases de Educación Física. Se revisaron 22 trabajos centrados en estrategias de inclusión para Educación Física en las bases de datos SciELO, Google Académico y Dialnet. A partir de los resultados obtenidos, se procedió a la sistematización y se diseñaron estrategias para mejorar la experiencia de aprendizaje y promover la igualdad, entre ellas las que se adaptan al currículo y actividades; las de formación y sensibilización docente; y, las de cultura inclusiva y ambiente positivo. Se concluye que la inclusión educativa es un proceso complejo que demanda cambios en actitudes, metodologías y políticas educativas.
O casamento entre teoria e prática é crucial para o ensino equitativo, e são necessárias estratégias flexíveis e eficazes para garantir a inclusão. O objetivo deste artigo foi propor estratégias para a participação de alunos com deficiência nas aulas de educação física. Vinte e dois artigos com foco em estratégias de inclusão para a Educação Física foram revisados nas bases de dados SciELO, Google Scholar e Dialnet. Com base nos resultados obtidos, foram sistematizadas e elaboradas estratégias para melhorar a experiência de aprendizagem e promover a igualdade, incluindo aquelas adaptadas ao currículo e às atividades; treinamento e conscientização dos professores; e cultura inclusiva e ambiente positivo. Conclui-se que a inclusão educacional é um processo complexo que exige mudanças de atitudes, metodologias e políticas educacionais.
The union of theory and practice is crucial for equitable teaching, and flexible and effective strategies are required to ensure inclusion. The objective of this article was to propose strategies for the participation of students with disabilities in Physical Education classes. Twenty-two works focused on inclusion strategies for Physical Education were reviewed in the SciELO, Google Academic and Dialnet databases. Based on the results obtained, the systematization was carried out and strategies were designed to improve the learning experience and promote equality, including those that adapt to the curriculum and activities; those of teacher training and awareness; and, those with an inclusive culture and positive environment. It is concluded that educational inclusion is a complex process that demands changes in attitudes, methodologies and educational policies.
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Introducción: la creciente preocupación por eventos epidémicos de origen zoonótico generó la necesidad de estrategias integrales que corrigiesen la baja adaptabilidad y tensiones que se generan al implementar acciones de orden jerárquico superior en el contexto comunitario. Con el objeto de explicar un Enfoque Rápido en Contexto Comunitario (ERCC), este trabajo se propone evaluar dentro del contexto de un programa de salud pública la participación comunitaria en la prevención del Hantavirus en la Comarca Andina del Paralelo 42. Metodología: El presente ERCC utilizó visitas y observaciones al sitio, entrevistas cara a cara y grupales, precedidas por una revisión documental de la literatura. La información se recopiló en un corto período de tiempo y el análisis se utilizó para desarrollar recomendaciones informadas para los tomadores de decisiones de salud pública. Resultados: Se observo que cada comunidad enfrenta desafíos más allá del hantavirus y es esencial que epidemiólogos, prestadores de servicios asistenciales y municipalidades trabajen más estrechamente con la población local para prevenir y manejar mejor cualquier brote de enfermedad. Se pudieron identificar 6 recomendaciones que le permitirían a las comunidades un mejor manejo de futuros brotes con un enfoque participativo. Conclusiones: El ERCC es una intervención rápida y discreta que puede ser llevada a cabo por un pequeño equipo con una interferencia mínima en la comunidad. El ERCC también podría ser adaptado por las autoridades de salud pública a muchos contextos diferentes, incluso con grupos vulnerables, para ayudar a que la promoción y la prevención sean más relevantes y efectivas a nivel local (AU)
Introduction: the growing concern for epidemic events of zoonotic origin generated the need for comprehensive strategies that correct the low adaptability and tensions generated when implementing actions of higher hierarchical order in the community context. In order to explain a Rapid Approach in Community Context (ERCC), this paper aims to evaluate within the context of a public health program community participation in the prevention of Hantavirus in the Andean Region of the 42nd Parallel. Methodology: The present ERCC used site visits and observations, face-to-face and group interviews, preceded by a documentary review of the literature. The information was collected over a short period of time and the analysis was used to develop informed recommendations for public health decision makers. Results: It was observed that each community faces challenges beyond hantavirus and it is essential that epidemiologists, care providers and municipalities work more closely with the local population to better prevent and manage any disease outbreak. We were able to identify 6 recommendations that would allow communities to better manage future outbreaks with a participatory approach. Conclusions: The ERCC is a rapid and discreet intervention that can be carried out by a small team with minimal interference in the community. The ERCC could also be adapted by public health authorities to many different contexts, including with vulnerable groups, to help make promotion and prevention more relevant and effective at the local level (AU)
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Humans , Preventive Health Services , Local Health Strategies , Orthohantavirus , Community Participation , Communicable Disease Control/instrumentation , Intersectoral CollaborationABSTRACT
Este artigo apresenta resultados preliminares de uma investigação sobre a aderência de propostas de criação de uma política de comunicação aos princípios de comunicação pública no Sistema Único de Saúde. As proposições foram discutidas no âmbito das Conferências Nacionais de Saúde realizadas entre 2003 e 2019. O estudo abrangeu a avaliação de documentos e entrevistas em profundidade com fontes-chave com atuação no controle social e que participaram das conferências. Buscaram-se também subsídios teóricos que tratam das temáticas da comunicação pública e da comunicação em saúde para embasar a discussão sobre a elaboração de uma política de comunicação voltada para o SUS. Observa-se falta de ancoragem clara das propostas das conferências com relação aos princípios da comunicação pública, bem como a não adesão do governo federal à pauta, mesmo nas gestões afinadas com ideais democráticos, princípios de participação social e atuação no interesse público.
This article presents the preliminary results of an investigation into the adherence of the proposals to create a communication policy for the Unified Health System, according to the principles of public communication. Those proposals were held between 2003 and 2019 within the National Health Conferences scope. The study covered the evaluation of documents and in-depth interviews with key sources working in social control and who had participated in conferences. It also included theoretical subsidies that deal with the themes of public communication and communication and health to support the discussion on the creation of a communication policy aimed at the SUS. The results showed a lack of clear anchorage of the conference proposals in principles of public communication, and the non-adherence of the federal government to the agenda, even during governments aligned with democratic ideals, principles of social participation, and action on the public interest.
Este artículo presenta resultados preliminares de una investigación sobre la adhesión de las propuestas de creación de una política de comunicación del Sistema Único de Salud a los principios de la comunicación pública. Las proposiciones fueron discutidas en las Conferencias Nacionales de Salud, entre 2003 y 2019. El estudio abarcó la evaluación de documentos y entrevistas en profundidad con fuentes que trabajan en el control social y con participación en las conferencias. Se buscaron subsidios teóricos que tratan de los temas de comunicación pública y comunicación y salud para apoyar la discusión sobre la elaboración de una política de comunicación dirigida al SUS. Hay una falta de anclaje de las propuestas de la conferencia en principios de comunicación pública, así como la falta de adhesión del gobierno federal, incluso en gestiones en sintonía con los ideales democráticos, principios de participación y acción social centrado en el interés público.
Subject(s)
Social Control, Formal , Unified Health System , Communication , Health Conferences , Public Policy , Computer Security , Health PolicyABSTRACT
Objective:To explore the effectiveness of patient participation and Internet plus in fall prevention management strategies of elderly inpatients and analyze the causes of falls, so as to provide a basis for continuous improvement in fall prevention to investigate their continuous improvement.Methods:A pre- and post-control study was conducted. Totally 8 480 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2020 to 31 May 2021 in Chenzhou NO. 1 People′s Hospital were selected by convenient sampling as the control group, and 8 662 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2021 to 31 May 2022 were in the experimental group. The routine fall prevention measures were used in the control group, and on this basis, the experimental group formulated and implemented fall prevention management strategies involving patients based on the patient participation framework "informing, participating, empowering, cooperating, and electronic information support" and introduced Internet plus. Then the differences between the two groups in terms of the incidence of falls and the satisfaction rate of nursing care were compared.Results:The experimental group included 8 662 cases (5 110 males and 3 552 females) with (73.96 ± 8.78) years old, while the control group included 8 480 cases (4 918 males and 3 562 females) with (74.11 ± 8.59) years old. The incidence of falls in experimental group (0.092%, 8/8 662) was lower than that in control group (0.224%, 19/8 480), and the difference was statistically significant ( χ 2=4.71, P<0.05); the nursing care satisfaction rate of experimental group (98.880%, 8 565/8 662) was higher than that of control group (96.450%, 8 179/8 480), and the difference also was statistically significant ( χ 2=106.50, P<0.01); the analysis of the fall causes of the patients revealed that the toilet squatting commode was an important hidden risk of falls in elderly patients. Conclusions:Fall prevention management strategies based on patient participation can reduce the incidence of falls in elderly patients and improve the satisfaction rate of nursing care. Patient participation introduced "Internet plus" can prevent patient falls. The root causes of patient falls will continue to change, and care managers should continually track real-time changes in the root causes of falls to identify problems, develop and adjust prevention strategies accordingly, and pay attention to the importance of infrastructure in the safety of older patients.
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【Objective】 To analyze the association between preschool children′s emotional regulation ability and parents′ participation in accompanying picture book reading, in order to provide theoretical reference for improving children′s emotional regulation abilility. 【Methods】 From September to November 2022, preschool children aged 3 - 6 years from Guangfeng County, Yukan County, Wannian County, Yanshan County and Wuyuan County were selected by random cluster stratified sampling method. Mann-Whitney U test or Kruskal-Wallis H test were used to analyze the correlation of different levels of children′s emotional control ability with different demographic characteristics as well as parents′ participation in children′s picture book reading. Multivariate Logistic regression model was used to analyze the correlation between parents′ involvement in picture book reading and children′s emotional control ability. 【Results】 Finally 848 valid questionnaires were collected.The average age of children was (4.33±0.95)years old,with 432 boys and 416 girls. Multivariate Logistic regression analysis showed that the temperament control ability(>P75) of preschool children was positively correlated with mother being the main accompanying caregiver (OR=4.17, 95%CI: 2.13 - 8.17), and negatively correlated with father being the main accompanying caregiver (OR=0.38, 95%CI: 0.21 - 0.70) or both parents being the main accompanying caregivers (OR=0.14, 95%CI: 0.07 - 0.28)(P<0.05). The social confidence (father as the main caregiver OR=3.53, 95%CI:1.62 - 7.66; mother as the main caregiver OR=3.52, 95%CI: 1.66 - 7.45) and anxiety control abilities(father as the main caregiver OR=4.32, 95%CI: 1.85 - 10.09; mother as the main caregiver OR=3.39, 95%CI: 1.49 - 7.73) of preschool children were positively correlated with the type of accompanying caregiver(P<0.05). Additionally, the anxiety control ability (>P75) of preschool children was negatively correlated with father′s accompanying frequency (sometimes OR=0.09, 95%CI: 0.03 - 0.28; often OR=0.19, 95%CI: 0.06 - 0.60) and mother′s accompanying duration (<1h/d OR=0.33, 95%CI: 0.12 - 0.91) (P<0.05). 【Conclusions】 The frequency and duration of accompanying reading by father or mother are correlated with the emotional regulation ability of preschool children. Parents can moderately participate in picture book reading to promote the development of preschool children′s emotional control ability.
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@#Introduction: This systematic review aimed to investigate the level of participation, obstacles, and facilitator factors that influence activities of daily living among persons with spinal cord injury (SCI). Methods: A comprehensive search was conducted in four online databases, namely Google Scholar, PubMed, OT Seeker, and Cochrane Library covering the ten-years period from January 2012 to December 2022. Inclusion criteria encompassed original published studies in English focusing on daily activities, work, participation, obstacles, and facilitators in persons with SCI. Non-peer review sources (e.g., abstracts, grey literature, preprints), and studies unrelated to occupational therapy were excluded. The selected studies were assessed for quality using McMaster University Occupational Therapy Evidence-Based Practice critical review form. Results: Out of the 678 articles identified, ten studies were included after the screening, exploring participation in daily living activities, employment, return to work, leisure activities, family tasks, and community mobility among persons with SCI. Obstacles and facilitators influencing participation in activities of daily living were classified using the International Classification of Functioning, Disability, and Health (ICF) framework. This review highlighted that long-term participation is challenging for persons with SCI, affected by obstacles such as body functions, pain, low self-esteem, and environmental and social factors. Conclusion: The findings underscore the importance of adopting a multidisciplinary rehabilitation approach to enhance participation in daily activities for persons with SCI. Occupational therapy plays a significant role in improving participation levels among persons with SCI.
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@#A school visit is defined as a process wherein a person with specific expertise and preparation goes to a school for a limited period of time and gathers information on how a student is functioning within that setting. Aside from giving thorough guidelines for conducting a school visit, the 5P Stairs Model presents five (5) steps that can establish a better working relationship among the stakeholders, motivated by one main goal: to support the child’s performance within the school setting. The model presents the 5P’s: a) Preparation, which focuses on the delivery of consent and request letters upon identifying the need for a visit; b) Pre-observation for the briefing, focusing on the collaboration between the therapist and the teacher on how the process could mutually benefit them and the child; c) Observation Proper which includes taking note of relevant observations using a checklist; d) Post-observation for debriefing is where feedback to the teacher takes place; and e) Planning and Partnership which includes providing recommendations and necessary interventions, through the continuous collaboration among the therapist, family, and school. Furthermore, supplemental materials such as template letters, a questionnaire, and an observation form were developed to facilitate the aforementioned steps. The framework’s processes and steps serve as a guide and are not meant to be prescriptive. A pilot study on the 5P Stairs Model’s processes and supplemental files is recommended to help establish its usefulness, validity, and effectiveness.
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Schools , Education , Occupational TherapyABSTRACT
Resumo A participação de crianças com paralisia cerebral (PC) em atividades de recreação e lazer pode ser influenciada por fatores ambientais. O reconhecimento e compreensão desses fatores como barreiras ou facilitadores dessas atividades são essenciais para garantir o direito de participação dessas crianças em condições de igualdade com as demais pessoas da sociedade. Neste contexto, o objetivo desta revisão integrativa foi identificar as barreiras e facilitadores ambientais na participação de crianças com PC em atividades de recreação e lazer. Utilizou-se o método de revisão integrativa proposto por Whittemore e Knafl (2005). Estudos publicados entre 2011 e 2022 nos idiomas português e/ou inglês foram selecionados a partir das fontes de indexação MEDLINE via PubMed, EMBASE, SciELO, LILACS, SCOPUS e Web of Science. Nove estudos foram incluídos na revisão - a maioria de desenho transversal e abordagem qualitativa. Os seguintes facilitadores da participação foram identificados: apoio dos pais, pares e professores; interação com adultos; terapias; condições materiais; atividades em casa, na escola e na comunidade; diversidade de brinquedos; e atividades culturais. As seguintes barreiras à participação foram identificadas: falta de acesso a transportes públicos; atitudes negativas; falta de escolha e menor interação dos pais; e falta de adequação das atividades. A Classificação de Funcionalidade, Incapacidade e Saúde (CIF) e os conceitos pirâmide de participação e família de constructos foram fundamentais para identificar as barreiras e facilitadores ambientais na participação de crianças com PC. Sugere-se que estudos futuros sejam conduzidos para avaliar a qualidade e a força da evidência para participantes com 11 anos de idade incompletos.
Abstract The participation of children with cerebral palsy (CP) in recreation and leisure activities can be influenced by environmental factors. The recognition and understanding of these factors as barriers or facilitators of these activities are essential to guarantee the right of these children to participate on equal terms with other people in society. In this context, the objective of this integrative review was to identify environmental barriers and facilitators in the participation of children with CP in recreation and leisure activities. The integrative review method proposed by Whittemore and Knafl (2005) was used. Studies published between 2011 and 2022 in Portuguese and/or English were selected from MEDLINE indexing sources via PubMed, EMBASE, SciELO, LILACS, SCOPUS and Web of Science. Nine studies were included in the review - most of them cross-sectional in design and qualitative in approach. The following participation facilitators were identified: support from parents, peers and teachers; interaction with adults; therapies; material conditions; activities at home, school and in the community; diversity of toys; and cultural activities. The following barriers to participation were identified: lack of access to public transport; negative attitudes; lack of choice and less parental interaction; and lack of adequacy of activities. The Classification of Functioning, Disability and Health (ICF) and the concepts of participation pyramid and family of constructs were fundamental in identifying environmental barriers and facilitators in the participation of children with CP. It is suggested that future studies be conducted to assess the quality and strength of the evidence for participants under 11 years of age.
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RESUMO Objetivo analisar a relação entre a participação social e a condição de fragilidade física de idosos hospitalizados. Método estudo transversal analítico, desenvolvido em um hospital público no sul do Brasil. Utilizou-se questionários sociodemográficos e clínicos, inventário de atividades e testes do fenótipo de fragilidade. Empregaram-se análises descritivas, teste de Kruskal-Wallis e comparações múltiplas de Dunn. Resultados dos 124 idosos avaliados, 54,8% eram do sexo masculino, 46% casados, 14,5% não frágeis, 39,5% pré-frágeis, 46% frágeis. Houve aumento crescente da condição de não frágil, pré-frágil e frágil nos domínios, nunca tem contato por meio de cartas ou e-mail (22,2%; 40,8%; 61,4%), nunca presta assistência a outras pessoas (27,8%; 40,8%; 80,7%), nunca realiza trabalho voluntário (77,8%; 77,6%; 98,2%), nunca viaja (33,3%; 53,1%; 84,2%), nunca sai com pessoas para atividades de lazer (16,7%; 28,6%; 56,1%), nunca participa de atividades sociais (38,9%, 44,9%; 75,4%), nunca faz uso de computador e internet (50%, 55,1%; 86%) e nunca dirige veículos (66,7%, 63,3%; 94%). Conclusão idosos com menor participação social apresentam maior risco de transição para fragilidade física. Implicações para a prática os domínios de participação social devem ser incluídos no plano de cuidados no contexto hospitalar, como uma estratégia para prevenir e/ou reverter a condição de fragilidade em idosos.
RESUMEN Objetivo analizar la relación entre participación social y condición de fragilidad física de adultos mayores hospitalizados. Método estudio transversal, desarrollado en un hospital público del sur de Brasil. La recolección de datos se realizó de marzo a mayo de 2023, mediante cuestionarios sociodemográficos y clínicos, inventario de actividad y pruebas de fenotipo de fragilidad física. Se utilizaron análisis descriptivos, la prueba de Kruskal-Wallis y comparaciones múltiples de Dunn. Resultados de los 124 adultos mayores evaluados, 14,5% eran no frágiles, 39,5% prefrágiles y 46% frágiles. Hubo un aumento creciente en el estatus de no frágil, prefrágil y frágil en los dominios, nunca tiene contacto con otras personas a través de cartas o correo electrónico (22,2%; 40,8%; 61,4%), nunca realiza trabajo voluntario (77,8%; 77,6%; 98,2%), nunca viaja (33,3%; 53,1%; 84,2%), nunca sale para actividades de ocio (16,7%; 28,6%; 56,1%), nunca participa en actividades sociales (38,9%, 44,9%; 75,4%), nunca conduce vehículos (66,7%, 63,3%; 94%). Conclusión las personas mayores que nunca practican actividades de participación social tienen mayor riesgo de transición a la fragilidad física. Implicación para la práctica los dominios de participación social deben ser incluidos en el plan de atención en el contexto hospitalario, como apoyo adicional para prevenir y/o revertir la fragilidad en adultos mayores.
ABSTRACT Objective to analyze the relationship between social participation and physical frailty condition of hospitalized older adults. Method analytical cross-sectional study, developed in a public hospital in southern Brazil. Data collection took place from March to May 2023, using sociodemographic and clinical questionnaires, an activity inventory and physical frailty phenotype testing. Descriptive analyses, the Kruskal-Wallis test and Dunn's multiple comparisons were used. Results of the 124 older people evaluated, 54.8% were male, 14.5% non-frail, 39.5% pre-frail, 46% frail. There was a growing increase in the status of non-frail, pre-frail and frail in the domains, never has contact with other people through letters or e-mail (22.2%; 40.8%; 61.4%), never provides assistance to other people (27.8%; 40.8%; 80.7%), never performs voluntary work (77.8%; 77.6%; 98.2%), never travels (33.3%; 53.1%; 84.2%), never goes out with people for leisure activities (16.7%; 28.6%; 56.1%), never participates in social activities (38.9%, 44.9%; 75.4%), never drives vehicles (66.7%, 63.3%; 94%). Conclusion older adults who never practice social participation activities are at greater risk of transitioning to physical frailty. Implication for practice the domains of social participation should be included in the care plan in the hospital context, as further support to prevent and/or reverse frailty in the older population.
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A participação social está nos debates sobre as transformações e a diversidade teórico-metodológica na Terapia Ocupacional. Com esse contexto, buscou-se identificar se a participação social, em seu âmbito teórico-prático, é abordada no processo de formação graduada em Terapia Ocupacional e como tem sido trabalhada com os alunos. De maneira colaborativa, terapeutas ocupacionais docentes de instituições de ensino superior públicas e privadas responderam a um questionário. A maioria incluiu o conceito nas discussões teóricas e na construção de práticas e pesquisas dentro e fora da sala de aula. Há relação entre os diferentes campos de atuação; ensino; pesquisa e extensão; modos e metodologias de trabalho; população atendida; seus contextos de vida, demandas e necessidades; e os pontos de vista sobre a participação social. Isso exemplifica a flexibilização dos currículos e a possibilidade de traçar diferentes caminhos para formação graduada.
Public participation is part of the debate about transformations and theoretical and methodological diversity in occupational therapy. The aim of this study was to identify whether theoretical and practical aspects of public participation are addressed in undergraduate occupational therapy training and how it has been approached with students. Occupational therapy teachers from public and private universities answered a questionnaire. Most teachers included the concept in theoretical discussions and the development of practices and research inside and outside the classroom. There is a relationship between different fields of work, teaching, research and extension, working methods and methodologies, the population treated and their life contexts, demands and needs, and points of view of public participation. This exemplifies the flexibilization of curriculums and the possibility to chart different pathways for undergraduate training.
La participación social está en los debates sobre las transformaciones y la diversidad teórico-metodológica en la terapia ocupacional. Con ese contexto, se buscó identificar si la participación social, en su ámbito teórico-práctico, se aborda en el proceso de formación graduada en terapia ocupacional y cómo se aborda con los alumnos. De manera colaborativa, terapeutas ocupacionales docentes de instituciones de enseñanza superior públicas y privadas respondieron un cuestionario. La mayoría incluyó el concepto en las discusiones teóricas y en la construcción de prácticas y de investigaciones dentro y fuera del aula. Hay una relación entre los diferentes campos de actuación, enseñanza, investigación y extensión, los modos y metodologías de trabajo, la población atendida, sus contextos de vida, demandas y necesidades y los puntos de vista sobre la participación social. Eso ejemplifica la flexibilización de los currículos y la posibilidad de trazar diferentes caminos para la formación graduada.