A preventive care approach for oral health in nursing homes: a qualitative study of healthcare workers' experiences.

BACKGROUND: Oral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers' experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes. METHODS: Healthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data. RESULTS: Themes generated in the analysis were: (1) A structured process promotes communication and awareness and stresses the importance of oral health; (2) Oral care for frail older adults is challenging and triggers ethical dilemmas; (3) Unclear responsibilities, roles and routines in the organization put oral health at risk; (4) Differences in experience and competence among healthcare staff call for educational efforts. CONCLUSIONS: The structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents' reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.

Examining unconscious bias embedded in provider language regarding children with autism.

In healthcare settings, language used by healthcare providers can influence provider-patient encounters with individuals with autism spectrum disorder, impacting feelings of stigma and marginalization. This study highlights the unconscious biases healthcare providers might have regarding their patients with autism spectrum disorder and how those beliefs are articulated. Seven pediatric dentists participated in two focus groups to describe strategies to improve oral care for children with autism spectrum disorder. While completing the primary analyses, additional codes emerged related to healthcare provider biases; these data are the focus of this study. Three themes were identified: (i) "healthcare microaggressions" describe how healthcare providers portray their patients in subtly negative ways; (ii) "marginalization" denotes the use of exclusionary language identifying children with autism spectrum disorder as different; and (iii) "preconceptions" include comments that highlight biases about patients. The findings provide insight into the implicit biases that might be held by healthcare providers and how they manifest in language. Despite increased emphasis on cultural competency, healthcare providers might unconsciously use language that could negatively impact patient-provider rapport and increase stigma in already marginalized populations. Further research is necessary to explore how these biases could relate to quality of care.

The conceptual understanding of pediatric palliative care: a Swiss healthcare perspective.

BACKGROUND: Health care providers' perception of pediatric palliative care might negatively influence timely implementation. The aim of the study was to examine understanding of and attitudes towards pediatric palliative care from the perspective of health care providers working in pediatric oncology in Switzerland to promote the timely implementation of pediatric palliative care. METHODS: Five mixed focus groups were conducted with 29 health care providers (oncologists, nurses, psychologists, and social workers) at five Swiss pediatric oncology group centers. The focus group interviews were analyzed using thematic coding. RESULTS: Most participants associated pediatric palliative care with non-curative treatment. They regularly reported difficulties in addressing palliative care services to families due to the strong stigma surrounding this term. They also thought that the notion of palliative care is very much linked to a policy context, and difficult to reconcile with children's everyday life. To overcome these obstacles many participants used synonyms such as comfort or supportive care. A few providers insisted on the need of using palliative care and reported the importance of positive "word of mouth". CONCLUSIONS: The use of synonyms might be a pragmatic approach to overcome initial barriers to the implementation of palliative care in pediatrics. However, this tactic might ultimately prove to be ineffective as these terms might acquire the same negative connotations as palliative care. Positive word-of-mouth by satisfied families and healthcare providers might be a more sustainable way to advocate for pediatric palliative care than replacing it with a euphemistic term.

Focus group methods in dental research.

INTRODUCTION: Focus group methods have been increasingly used in dental research. However, although focus group methods appear quite simple and easy to carry out, there are a number of complexities that need to be considered. METHOD: The present integrative review was carried out to assess the usability of focus group methods for dental research. RESULTS: Three key themes were identified from the qualitative review: the complexity of the method; benefits of focus group research for dentistry; and, the nature of the quality controls employed. CONCLUSION: A key strength of using focus groups is that they can enhance qualitative and quantitative methodologies by helping to clarify, extend, qualify, or challenge what has been found.

"Pictures don't lie, seeing is believing": exploring attitudes to the introduction of pictorial warnings on cigarette packs in Ghana.

PURPOSE: To compare perceptions of text and pictorial warning labels on cigarette packs among Ghanaian smokers and nonsmokers and to explore their views on the introduction of pictorial warnings in Ghana. METHODS: Qualitative study involving 12 focus group discussions with 50 smokers and 35 nonsmokers aged 15 years and older in Kumasi, Ghana. Semistructured discussion guides along with visual discussant aids were used to explore the perception, acceptance, and potential use of pictorial warning labels in Ghana. RESULTS: Health warnings combining text and a picture were perceived by both smokers and nonsmokers to communicate health messages more effectively than text-only or picture-only warnings. The effect of text-only warnings was considered limited by low levels of literacy and by the common practice of single stick sales rather than sales of packs. Of the 6 health warnings tested, lung cancer, blindness, stroke, and throat/mouth cancer messages were perceived to have the most impact on smoking behavior, including uptake and quit attempts. CONCLUSIONS: Warning labels combining pictures and text have the potential to reduce smoking uptake, increase quit attempts, and reduce smoking appeal among smokers and nonsmokers in Ghana. Measures to prevent single stick sales, or to promote health messages to purchasers of single sticks, are required.

Cultural beliefs and health-seeking practices: Rural Zambians' views on maternal-newborn care.

BACKGROUND: - Far too many newborns die or face serious morbidity in Zambia, as in many other sub-Saharan African countries. New knowledge is needed to enhance our understanding of newborn care and the cultural factors influencing the ways mothers seek newborn care. This study adds to the literature about rural Zambians' cultural beliefs and practices related to newborn care and health-seeking practices that influence maternal-newborn health. OBJECTIVE: - The goal of this study was to describe the factors associated with newborn care in rural Zambia. DESIGN: - Sixty focus groups were conducted. Each group contained a minimum of 8 and maximum of 12 participants. Recruitment was conducted orally by word of mouth through the nurse in charge at the health facilities and village chiefs. SETTING: - Data were collected between June and August 2016 in 20 communities located in Zambia's rural Lundazi (Eastern province), Mansa, and Chembe (Luapula province) Districts. PARTICIPANTS: - The study included community members (n = 208), health workers (n = 225), and mothers with infants younger than 1-year-old (n = 213). FINDINGS: - The following themes emerged. From mothers with infants, the dominant theme concerned traditional and protective newborn rituals. From community members, the dominant theme was a strong sense of family and community to protect the newborn, and from health workers, the major theme was an avoidance of shame. A fourth theme, essential newborn care, was common among all groups. KEY CONCLUSIONS: - Together the themes pointed toward a maternal dualism for mothers in rural Zambia. Mothers with infants in rural Zambia likely experience a dualistic sense of responsibility to satisfy both cultural and health system expectations when caring for their newborns. Mothers are pulled to engage in traditional protective newborn care rituals while at the same time being pushed to attend ANC and deliver at the health facility. These findings can be used to understand how mothers care for their newborns to develop interventions aimed at improving maternal-child health outcomes. IMPLICATIONS FOR PRACTICE: - There were findings about the culture-specific prevention of cough, care of the umbilical cord, and early introduction of traditional porridge that carry implications for nursing practice. There is an obvious need to reinforce the importance of partner testing for STIs during routine ANC even though there is a desire to preserve dignity.

Using innovative group-work activities to enhance the problem-based learning experience for dental students.

Problem-based learning (PBL) in medical and dental curricula is now well established, as such courses are seen to equip students with valuable transferable skills (e.g. problem-solving or team-working abilities), in addition to knowledge acquisition. However, it is often assumed that students improve in such skills without actually providing direct opportunity for practice, and without giving students feedback on their performance. 'The Manchester Dental Programme' (TMDP) was developed at The University of Manchester, UK as a 5-year, integrated enquiry-led curriculum. The existing PBL course was redesigned to include a unique, additional PBL session ('Session 4') that incorporated an activity for the group to complete, based on the subject material covered during student self-study. A summative mark was awarded for each activity that reflected the teamwork, organisational and overall capabilities of the groups. This paper describes the different types of activities developed for the Session 4 and presents an analysis of the perceptions of the students and staff involved. The student response to the Session 4 activities, obtained via questionnaires, was extremely positive, with the majority finding them fun, yet challenging, and 'worthwhile'. The activities were perceived to enhance subject understanding; develop students' problem-solving skills; allow the application of knowledge to new situations, and helped to identify gaps in knowledge to direct further study. Staff found the activities innovative and exciting learning tools for the students. The Session 4 activities described here are useful educational resources that could be adapted for other PBL courses in a wide variety of subject areas.

An exploration of student nurses' views of oral health care in the hospitalised child: A qualitative study.

Hospitalization impacts negatively on oral health, where underlying medical conditions and interventions such as oxygen therapy and nil-by-mouth status increase susceptibility to complications. However, evidence suggests it is often overlooked, or viewed as low priority by nurses. The rationale for these beliefs is unclear. This study provides an exploration of these beliefs, focusing specifically on their development, as reflected in the experiences of adult and paediatric student nurses. Three focus groups were conducted, and thematic analysis applied. Whilst students theoretically understood the value of oral health care, in hospital it was overlooked, with other 'clinical' aspects of care valued more highly. 'Hierarchy of need' emerged as the over-arching theme. Interrelated sub-themes included: 'practice/theory mismatch,' highlighting lack of education and adequacy of exposure to oral health care encounters; 'resources,' where infrastructure was lacking; and 'disempowerment,' where students felt powerless to act. Exposure to oral health care encounters were less frequent in the paediatric setting, risking disempowerment of parents as well as students. These findings highlight the need to raise the profile of oral health care, both theoretically and practically, engendering a culture that embeds mouth care unobtrusively into day-to-day nursing practice, improving health care outcomes for those in our care.

Portfólio: percepção de estudantes de graduação da área da saúde / Portafolio: percepción de los estudiantes de pregrado en eláreade la salud / Portfolio: perception of undergraduate students in the healthcare field

Introdução:A formação em saúde norteia a prática profissional, incidindo diretamente na atenção e assistência à saúde ofertada à população. Nesse sentido, o uso de métodos ativos de aprendizagem e avaliação, como por exemplo, o portfólio, podem contribuir para a construção de conhecimentos crítico-reflexivos. Objetivo:Evidenciara percepção de estudantes dos cursos da área da saúde, que cursam a disciplina de Saúde e Cidadania na Universidade Federal do Rio Grande do Norte sobre o uso do portfólio enquanto instrumento de avaliação do ensino aprendizagem. Metodologia:Os dados foram obtidos por meio da formação de grupo focaleanalisados pela análise do conteúdo. Definiram-se, então, as categorias temáticas:percepção sobre o portfólio; a elaboração do portfólio e a sua contribuição para a formação; dificuldades para formulação doportfólio;o portfólio como instrumento de avaliação. Resultados:Os estudantes compreendem o portfólio como instrumento de diálogo entre docentes e discentes, através dos relatos das vivências em grupo nos equipamentos sociais e reflexões individuais na construção de conceitos e aprofundamento teórico. Ainda referem inseguranças e dúvidas acerca da estruturação e confecção do instrumento, no entanto, percebem o portfólio como potente e inovador no auxílio aconstrução do conhecimento uma vez que permite oacompanhamento do processo de ensino-aprendizagem, possibilitando maior interação entre educador-educando, com produção de uma aprendizagem significativa.Conclusões:o portfólio estimula a reflexão e a crítica acerca das vivências nos cenários de práticas onde se desenvolve o componente curricular Saúde e Cidadaniacorroborando, sobremaneira, para a construção do conhecimento dos estudantes (AU).

Introduction:A degreein healthcare guides the professional practice, directly affecting the healthcare attention and assistance offered to the population. In this sense, the use of active learning and assessment methods, such as portfolios, can contribute to the construction of critical-reflective knowledge. Objective:To highlight the perception of students from health courses, who study the Health and Citizenship discipline at the Federal University of Rio Grande do Norte, regarding the use of the portfolio as an instrument for evaluating teaching and learning.Methodology:Data were obtained through the formation of a focus group and analyzed using content analysis. Thematic categories were then defined: perception of the portfolio; the preparation of the portfolio and its contribution to training; difficulties in formulating the portfolio; the portfolio as an assessment tool. Results:Students understand the portfolio as an instrument of dialogue between teachers and students, through reports of group experiences in social facilities and individual reflections in the construction of concepts and theoretical deepening. They still report insecurities and doubts about the structuring and creation of the instrument, however, they perceive the portfolio as powerful and innovativein helping to build knowledge as it allows the monitoring of the teaching-learning process, enabling greater interaction between educator and student, with the production of significant learning. Conclusions:The portfolio encourages reflection and criticism about the experiences in the practical scenarios where the curricular component -SACI is developed, greatly supporting the construction of students' knowledge (AU).

Introducción:La formación en salud orienta la práctica profesional, incidiendo directamente en la atención y asistencia sanitaria que se ofrece a la población. En este sentido, el uso de métodos activos de aprendizaje y evaluación, como los portafolios, puedecontribuir a la construcción de conocimiento crítico-reflexivo. Objetivo:Resaltar la percepción de estudiantes de carreras de salud, que cursan la disciplina Salud y Ciudadanía de la Universidad Federal de Rio Grande do Norte, sobre el uso del portafolios como instrumento de evaluación de la enseñanza y del aprendizaje. Metodología:Los datos se obtuvieron mediante la formación de un grupo focal y se analizaron mediante análisis de contenido. Luego se definieron categorías temáticas: percepción del portafolio; la elaboración del portafolio y su contribución a la formación; dificultades para formular el portafolio; el portafolio como herramienta de evaluación.Resultados:Los estudiantes entienden el portafolio como un instrumento de diálogo entre docentes y estudiantes, a través de relatos de experiencias grupales en establecimientos sociales y reflexiones individuales en la construcción de conceptos y profundización teórica. Aún reportan inseguridades y dudas sobre la estructuración y creación del instrumento, sin embargo, perciben el portafolio como poderoso e innovador para ayudar a la construcción de conocimiento ya que permite el seguimiento del proceso de enseñanza-aprendizaje, posibilitando una mayor interacción entre educador y estudiante, con la producción de aprendizajes significativos.Conclusiones: El portafolio incentiva la reflexión y crítica sobre las experiencias en los escenarios prácticos donde se desarrolla el componente curricular -SACI, apoyando en gran medida la construcción del conocimiento de los estudiantes (AU).

Impacts of health of users with HIV/AIDS in a specialized service.

OBJECTIVE: to understand the perception of users of a Specialized Care Service (SAE- Serviço de Assistência Especializada) in HIV/AIDS about their oral health. METHOD: qualitative research that used the techniques of participant observation and focal group. For the analysis of the material produced, categories of analysis, construction of dialogical map and identification of linguistic repertoires were used. RESULTS: impacts arising from oral health problems such as: inability to eat properly, feeling ashamed due to tooth loss, inability to perform physical exercises and, as the main barrier to access to dental treatment, fear of exposure to practices of discrimination and prejudice. FINAL CONSIDERATIONS: we need the implementation of policies of Permanent Education to all professionals involved in the care for this population, to ensure users' rights, ensure qualified care, and create security and trust relationships with individuals living with HIV/AIDS, in access to services.

Intervention, recruitment and evaluation challenges in the Bangladeshi community: experience from a peer lead educational course.

BACKGROUND: The incidence of Type 2 diabetes is increasing worldwide and diabetes is four times more common among ethnic minority groups than among the general Caucasian population. This study reflects on the specific issues of engaging people and evaluating interventions through written questionnaires within older ethnic minority groups. METHODS: The original protocol set out to evaluate an adapted version of the X-PERT patient program http://www.xpert-diabetes.org.uk/ using questionnaires and interviews. RESULTS: Questionnaires, even verbally completed, were unsuccessful and difficult to administer as participants found the questionnaire structure and design difficult to follow and did not perceive any benefit to completing the questionnaires. The benefits of attending the course were also poorly understood by participants and in many cases people participated in coming to the course as a favour to the researcher. Engaging participants required word of mouth and the involvement of active members of the community. CONCLUSION: Peer led courses and their evaluation in older ethnic minority communities needs a very different approach for that in younger Caucasian patients. A structured approached to evaluation (favoured by western educational system) is inappropriate. Engaging participants is difficult and the employment of local well known people is essential.

O olhar de usuários, residentes e trabalhadores sobre uma intervenção em saúde bucal de abordagem comunitária na ESFdo campo / Perspective of users, residents and workers on a community-based oral health intervention in the rural FHS

Objetivou-se analisar uma intervenção de cuidado integral em saúde bucal de abordagem comunitária protagonizada por residentes de Odontologia em Saúde da Família inseridos em duas unidades de saúde do campo de Caruaru/PE, segundo o olhar de profissionais, residentes e usuários. A intervenção englobou diagnóstico e levantamento das necessidades odontológicas, ações coletivas em saúde bucal e ações assistenciais para cárie com tratamento restaurador atraumático. Os grupos-alvo formam escolares e moradores de áreas mais remotas nas unidades de Lagoa de Pedra e de Xicuru. O estudo qualitativo utilizou técnica do grupo focal para coleta dos dados. Três grupos foram constituídos: nove profissionais, seis residentes e oito usuários. As entrevistas seguiram um roteiro com perguntas abertas sobre o cuidado e as tecnologias em saúde bucal empregadas no contexto das populações campesinas e acesso/acessibilidade às unidades de saúde. Os dados foram submetidos à análise de conteúdo. Emergiram duas categorias temáticas: dificuldades de acesso aos cuidados em saúde bucal e satisfação com as ações implementadas. Os participantes dos três grupos avaliaram positivamente a iniciativa de estabelecer relação educativa/assistencial participativa abrindo-se a espaços comunitários e valorizaram o enfoque adotado pela intervenção de saúde bucal no enfrentamento dos problemas limitadores do acesso aos serviços odontológicos e às ações coletivas que relataram. Contudo, desinteresse na continuidade das ações realizadas e contrários às práticas comunitárias em saúde bucal foram relatadas no grupo focal dos profissionais. Considera-se persistir fatores profissionais e de estrutura limitadores à garantia dos direitos de acesso à saúde aos usuários de áreas mais remotas às unidades de saúde (AU).

The aimof this study was to analyze a comprehensivecommunity-basedoral health care intervention carried out by residents of Dentistry in Family Health inserted in two health units in the rural area of the municipalityof Caruaru/PE, according to the perspective of professionals, residents and users. The intervention included diagnosis and assessment of dental needs, collective actions in oral health and actions for caries treatment with atraumatic restorative treatment. Target groupswere composed of schoolchildren and users frommore remote areas included in the health units of Lagoa de Pedra and Xicuru. The qualitative study used the focus group technique for data collection. Three groups were formed: nine professionals, six residents and eight users. Interviews followed a script with open questions about oral health care and technologies used in the context of ruralpopulations and access/accessibility to health units. Data were submitted to content analysis. Two thematic categories emerged: difficulties in accessing oral health care and satisfaction with implemented actions. Participants in the three groups positively evaluated the initiative ofestablishinga participatory educational/care relationship by opening up to community spaces and valued the approach adopted by the oral health intervention in dealing with problems that limit access to dental services and the reported collective actions. However, lack of interest in the continuity of actions carried out and contrary to community practices in oral health were reported in the focus group of professionals. There ispersistent presence of professional and structural factors that limit the guarantee of access to health ofusers frommore remote areas included inhealth units.

Self-perception of oral health among tertiary-care users: quanti-qualitative analysis with chronic kidney disease patients

Chronic kidney disease (CKD) has become a global public health challenge. The objective of this study was to analyze the relationship between self-perception of oral health and clinical condition among patients with CKD. This isa quanti-qualitative survey conducted in a CKD specialized service. The sample consisted of 60 patients who underwent oral examinations to have their severity of caries (DMFT) and need for dental prosthesis checked. Age, sex, time on dialysis, marital status, skin color, education and pre-existing diseases were also analyzed. Among the kidney patients who agreed to undergo the clinical examinations and showed communication skills, some were selected, and three focus groups were created, with the participation of a moderator and six to 10 kidney patients in each group. Their speeches were processed in the IRAMUTEQ software and analyzed through the similarity analysis and word cloud techniques. As for profile, the patients were aged 60.23 ± 10.87 years old; were male (73.33%); were on dialysis for 41.90 ± 56.57 months; were married (61.67%); were white (76.67%); had incomplete primary education (41.66%); had arterial hypertension (76.67%); had a DMFT index of 22.55 ± 8.39; 43.33% needed an upper complete denture; and 30.00% needed a lower complete denture. The similarity analysis revealed many doubts and uncertainties about current health services, which can be proven by the words 'no' and 'treatment'. The quanti-qualitative analysis showed a high rate of dental loss and the need for complete dentures and suggests inequities in oral health care for chronic kidney disease patients, especially in tertiary care. There was a positive representation regarding oral health, but the lexicographical analyses of the textual corpusconfirmed the self-perception of lack of dental care.

Galeria ilustrada da classificação internacional de funcionalidade e incapacidade em saúde: relato de experiência / Illustrated gallery of the international classification of functionality and disability in health: experience report / Galería ilustrada de la clasificación internacional de funcionalidad y discapacidad en salud: informe de experiencia

Introdução: A Síndrome Congênita do Zika constitui uma nova condição de saúde, advinda do surto do vírus Zika no Brasil no início do ano 2015. É caracterizada por um conjunto de anormalidades que envolve a desproporção craniofacial, irritabilidade, espasticidade, convulsões, dificuldades alimentares, anormalidades oculares e perda auditiva. Objetivo:Relatar a experiência do uso da Galeria Ilustrada da Classificação Internacional de Funcionalidade, Incapacidade e Saúde como auxílio para coleta de dados em pesquisa sobre funcionalidade e incapacidade em crianças com Síndrome congênita do Zika. Metodologia: Foram construídos 3 instrumentos visuais baseados na versão resumida da Classificação Internacional de Incapacidade e Funcionalidade em Saúde e aplicados com 32 pais de crianças com diagnóstico confirmado da Síndrome congênita do Zika. Foram capturadas as imagens da galeria ilustrada nos domínios de atividade e participação, funções do corpo e fatores ambientais, de modo a facilitar a elaboração de respostas das entrevistas. Resultados: O instrumento visual permitiu aos participantes da pesquisa um processo de entrevista dinâmico, compreensível e espontâneo através de uma melhor compreensão dos conceitosda Classificação Internacional de Incapacidade e Funcionalidade em Saúde, e desse modo permitiu aos pesquisadores obter suas percepções a respeito da condição de saúde dos filhos dos entrevistados. Conclusões: Ferramentas visuais envolvendo a galeria ilustrada podem ser utilizadas como auxílio na coleta de dados em pesquisas qualitativas que envolvem a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (AU).

Introduction:Congenital Zika Syndrome is a new health condition, arising from the Zika virus outbreak in Brazil in early 2015. It is characterized by a set of abnormalities involving craniofacial disproportion, irritability, spasticity, seizures, eating difficulties, eye abnormalities and hearing loss.Objective:To report the experience of using the Illustrated Gallery of the International Classification of Functioning, Disability and Health as an aid to data collection in research on functionality and disability in children with congenital Zika Syndrome.Methodology:Three visual instruments were builtbased on the abridged version of the International Classification of Disability and Functioning in Health and applied to 32 parents of children with a confirmed diagnosis of congenital Zika Syndrome. Images from the illustrated gallery were captured in the domains of activity and participation, body functions and environmental factors, in order to facilitate the elaboration of interview responses. Results:The visual instrument allowed research participants a dynamic, understandable and spontaneous interview process through a better understanding of the concepts of the International Classification of Disability and Functioning in Health, and thus allowed the researchers to obtain their perceptions about the condition of your children's health. Conclusions:Visual tools involving the illustrated gallery can be used as an aid in data collection in qualitative research involving the International Classification of Functioning, Disability and Health (AU).

Introducción:El síndrome de Zika congénito es una nueva condición de salud, que surge del brote del virus del Zika en Brasil a principios de 2015. Se caracteriza por un conjunto de anomalías que involucran desproporción craneofacial, irritabilidad, espasticidad, convulsiones, dificultades para comer, anomalías oculares y auditivas. pérdida. Objetivo:Informar la experiencia de utilizar la Galería Ilustrada de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud como ayuda para la recopilación de datos en la investigación sobre la funcionalidad y la discapacidad en niños con síndrome congénito del Zika. Metodología:Se construyeron tres instrumentos visuales basados en la versión abreviada de la Clasificación Internacional de Discapacidad y Funcionamiento en Salud y se aplicaron a 32 padres de niños con diagnóstico confirmado de síndrome congénito del Zika. Se capturaron imágenes de la galería ilustrada en los dominios de actividad y participación, funciones corporales y factores ambientales, con el fin de facilitar la elaboración de las respuestas de la entrevista. Resultados:El instrumento visual permitió a los participantes de la investigación un proceso de entrevista dinámico, comprensible y espontáneo a través de una mejor comprensión de los conceptos de la Clasificación Internacional de Discapacidad y Funcionamiento en Salud, y así permitió a los investigadores obtener sus percepciones sobre elestado de salud de sus hijos. Conclusiones:Las herramientas visuales que involucran la galería ilustrada se pueden utilizar para ayudar en la recopilación de datos en la investigación cualitativa que involucra la Clasificación Internacional de Funcionamiento, Discapacidad y Salud (AU).

Quality of Life in Patients with Chronic Oral Mucosal Conditions: A Qualitative Research

ABSTRACT Objective: To use qualitative research methods to evaluate the experiences of patients with chronic oral diseases. Material and Methods: Purposive sampling was used to recruit patients from the Oral Medicine Unit of Kerman University Dental School. An experienced independent facilitator convened the focus groups and conducted individual interviews in a non-clinical setting. Focus groups were mixed regarding their gender, age, chronic oral mucosal condition, time since diagnosis, and severity. A total of 39 patients participated in the study, including patients with oral lichen planus, pemphigus, recurrent aphthous stomatitis and leukoplakia. Results: Analysis of the interviews revealed that patient views could be divided into the following themes: biopsychosocial issues, treatment limitations and side effects, unpredictability of the conditions and the potential for malignant transformation. Chronic oral mucosal conditions affected patients' daily lives in various areas, from physical health and functioning to concerns about their future. Conclusion: The oral medicine practitioner's role in treating patients with chronic oral mucosal diseases extended beyond active management and symptomatic relief to the management of all aspects of these conditions that affected their daily lives.

Use of collaborative learning as atool to evaluate syndromic craniofacial anomalies / Uso da aprendizagem colaborativa como ferramenta para avaliar anomalias craniofaciais sindrômicas

Almost 30% of oral cleftsare associated with other structural abnormalities.However, little is known on orofacial characteristics related tothese cases since they are not systematically reported. To close this gap, we developed a collaborative learning approach supported by an interprofessional team aiming to systematicallydescribe oral findings and impactthe training of future professionals that hopefully will incorporate these descriptionsintotheir clinical practice. The methodological proposal consisted of small group sessions focusing on a particular syndrome or group of syndromes followed by examiningpatients with those conditions. Twenty cases were examined and studied over one semester andaset of conditions to be identified in the orofacial regionwasdefined. Here, we present a guideline that we suggest that dentists and dental institutions use. We also present the advantages of using collaborative learning as a tool in the training of the clinician (AU).

Quase 30% das fissuras orais estão associadas a outras anormalidades estruturais. No entanto, pouco se sabe sobre as características orofaciais relacionadas a esses casos, uma vez que não são relatados de forma sistemática. Para fechar essa lacuna, desenvolvemos uma abordagem de aprendizagem colaborativa apoiada por uma equipe interprofissional com o objetivo de descrever sistematicamente os achados orais e impactar o treinamento de futuros profissionais que, esperançosamente, irão incorporar essas descrições em sua prática clínica. A proposta metodológica consistia em sessões de pequenos grupos enfocando uma determinada síndrome ou grupo de síndromes seguidas de exame de pacientes com essas condições. Vinte casos foram examinados e estudados ao longo de um semestre e foi definido um conjunto de condições a serem identificadas na região orofacial. Aqui, apresentamos uma diretriz que sugerimos que os dentistas e instituições odontológicas utilizem. Também apresentamos as vantagens de usar a aprendizagem colaborativa como uma ferramenta no treinamento do clínico (AU).

Uso de cenário com pessoas com deficiência e seus familiares no ensino odontológico / Use of scenarios with people with disabilities and their families in dental education

O objetivo deste estudo foi usarum cenário envolvendo pessoas com deficiência, seus familiares e estudantes de Odontologia para avaliar a percepção dos estudantes a respeito das necessidades destas pessoas.Trata-se de um estudo qualitativo transversal no qual participaram 60 estudantesde Odontologia matriculados na disciplina de Clínica Integrada Para Pacientes com Necessidades Especiais. Formaram-se grupos focais quereceberam um questionário semiestruturado com questões que exploraram aspectos sobre o atendimento de pessoas com deficiência e da rotina destas pessoas. Na sequência utilizou-se um cenário no qual estudantes interagiram com pessoas com deficiência e seus familiares. Na última etapa os grupos formularam hipóteses a respeito do atendimento destes pacientes. Os dados coletados nos três momentos foram agrupados em categorias e temas e analisados no software Atlas Ti. Os principais resultados obtidos foram agrupados em categorias de acordo com a percepção dos estudantes antes e depois da criação do cenário. Os dados obtidos após a análise qualitativa revelam que antes da criação do cenário os estudantes se colocaram no centro da discussão argumentando que atender pessoas com deficiência seria uma oportunidade para desenvolver suas habilidades, sem se preocupar com a pessoa com deficiência em si. Após a criação do cenário parece ter havido uma mudança importante na percepção dos estudantes acerca dessas pessoas e de suas famíliase as palavras respeito e empatiaapareceram frequentemente nos textos produzidos pelos estudantes. Aproximar os estudantes da realidade vivida pela pessoa com deficiência e de sua família parece ser uma alternativa para educar o estudante de Odontologia (AU).

The aim of this study was to use a scenario involving people with disabilities, their families,and dental students to assess students'perceptions of the needs of peoplewithdisabilities. This is a qualitative cross-sectional study that included60 dentalstudents enrolled in the discipline of Integrated Clinical Careof Patients with Special Needs.Focus groups were formed and each group received a semi-structured questionnaire with questions aboutaspects of the care provided to people with disabilities andabouttheir routine.Ascenario wasthenused in which students interacted with people with disabilities and their families. In the last phase of the study, the groups formulated hypotheses about the care of these patients. The data collected inthree time periods were grouped into categories and themes and analyzed using the Atlas Ti software. The results obtained were categorizedaccording to the students' perception before and after the creation of the scenario. After the qualitative analysis, the data revealedthat,before the creation of the scenario, the students placed themselves at the center of the discussion,arguing that attending to people with disabilities would be an opportunity to develop their skills without worrying about peoplewith disabilities themselves. After the creation of the scenario,there seems to have been an important change in the students' perception of these people andoftheir families and the words 'respect'and 'empathy'appeared frequently in the texts produced by the students. Bringing students closer to the reality experienced by people with disabilities and their families seems to be an alternative to educate dentalstudents (AU).

Focus groups--what are they?

The use of focus groups has become common in many spheres of research, including dental research. This article provides an update on the history of focus groups, defines focus groups in the context of academic research and highlights their possible uses. Practical advice is provided on the conduct of focus groups and ethical considerations are discussed.

A educação popular em saúde com grupos de idosos diabéticos na estratégia saúde da família: uma pesquisa-ação / Popular education in health with groups of diabetic elderly in the Family Health Strategy: an Action-Research

Introdução:A Educação Popular em Saúde (EPS) remete indivíduos e grupos à troca de saberes e experiências, permitindo-lhes associar a saúde ao resultado das suas condições de vida levando a uma emancipação do sujeito. Objetivo:Promover ações educativas com portadores de Diabetes Mellitus (DM);realizar oficinas de capacitação em EPS com trabalhadores de saúde; e avaliar os resultados das ações realizadas para os trabalhadores e usuários, em uma Unidade de Saúde da Família em Natal/RN. Método:Trata-se de uma pesquisa-ação com o referencial teórico da Teoria da Educação Libertadora, centrada na pedagogia problematizadora. Participaram da pesquisa trinta trabalhadores de saúde e trinta e seis usuários diabéticos. As ações foram organizadas através de rodas de conversa, dinâmicas de grupo, narrativas de vida, relatos de experiências, e explicitação de saberes, desejos, limitações, crenças e valores socialmente construídos. A coleta dos dados foi realizada através da Técnica de Associação Livre de Palavras, entrevista semiestruturada e grupo focal. O material empírico foi submetido à análise de ocorrência com auxílio do programa IRAMUTEQ. Resultados:Foram geradas palavras, expressões e categorias, a partir dos temas abordados e de situações criativas mostrando que a EPS vem sendo incorporada timidamente no processo educativo dos sujeitos deste estudo e bem distante dos princípios de participação, organização de um trabalho político, ampliação dos espaços de diálogo, respeito, de solidariedade e tolerância entre os diversos atores envolvidos no enfrentamento dos problemas de saúde, fundamentais para o aperfeiçoamento na construção de práticas saudáveis da atenção básica. Conclusões:A utilização de práticas ativas de ensino-aprendizagem, centradas na ampliação da escuta e em capacitações sobre EPS, poderá possibilitar mudanças no cenário onde os usuários e trabalhadores de saúde atuam com a diabetes mellitus (AU).

Introduction:Popular Health Education (EPS) refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions.Objective:To know and promote educational actions with patients with diabetes Mellitus (DM); Perform training workshops in EPS with health workers; To know and develop participatory educative actions with diabetic groups; and evaluate the results of theactions performed for workers and users, in a family health unit in Natal/RN.Methods:This is an action research with the theoretical framework of liberating education theory, centered on problematizing pedagogy. Thirty health workers and 36 diabetic users participated in the study. The actions were organized through conversation wheels, group dynamics, life narratives, reports of experiences, and explication of knowledge, desires, limitations, beliefs and socially constructed values. Data collection was performed through the free word association technique, semi-structured interview and focal group. The empirical material was subjected to occurrence analysis (Bardin) with the aid of the Iramuteq program (Ratinaud; Marchand).Results:The data analyses originated words, expressions, categories, themes and creative situations showing that EPS is in process of construction, but still very incipient in primary care. words, expressions and categories were generated from the themes addressedand creative situations showing that the EPS has been incorporated timidly in the educational process of the subjects of this study and far from the principles of participation, organization of a political work, expansion of the spaces of dialogue, respect, solidarity and tolerance among the various actors involved in coping with health problems, fundamental for the improvement in the construction of Healthy practices of primary care.Conclusions:The use of active teaching-learning practices, centered on the amplification of listening and in training on EPS, may enable changes in the scenario where users and health workers act with diabetes mellitus (AU).

Revisiting the Basic Cycle: Prospects by Undergraduates' Students of a Brazilian Dentistry School

Objective: To analyze the perception of undergraduates' students in a Dentistry School about the impact of basic disciplines on their professional development, as well the integration of this knowledge with the professional sphere. Material and Methods: It is a qualitative research study carried out through focus groups comprised of dentistry students close to finishing their degree. The data were analyzed by the thematic content analysis. Results: Four categories derived from the empirical material: "Disassociation of basic disciplines within the professional cycle", "Autonomy or transference of responsibility", "Campus-DOD distancing" and "Humanization of health care from first moments". The narratives showed the difficulties faced in order to effect, indeed, integration between the basic cycle and the curricular components of the vocational cycle. It was also evident the decontextualization of the basic cycle with the perspective of approach with professional practice. In addition, student's protagonist posture and learning how to humanize health care were identified as important factors to be debated and improved in the curriculum from the beginning of the course. Conclusion: The difficulties faced in order to effect an actual integration between the basic disciplines and the professional disciplines bring undesirable consequences upon undergraduate, being fundamental that the construction of new pedagogical projects means an effective integration of the contents to the curriculum design, avoiding any fragmentation between the basic and vocational cycle.