RESUMEN
Introduction: primary care action strategies are relevant for disease prevention and health promotion, as well as for the initial management of suspected cases and the individual monitoring of patients with confirmed diagnoses of COVID-19. This study aimed to evaluate the outcome of clinical worsening and demographic, occupational, and clinical variables of workers with COVID-19 in a community health center at a public university in southeastern Brazil. Methods: a retrospective cohort study was conducted with 1,459 symptomatic workers with COVID-19. Data were extracted from the database of the unit's epidemiological surveillance center between March 2020 and March 2021. Results: The average age of participants was 41.1 (SD 10.8) years, most women (71.1%), who had obesity (19.9%) and hypertension (17.0%). Among the symptoms, headache (75.3%) and cough (74.9%) stood out. The worsening of clinical outcome during follow-up occurred in 3.4% of cases. The demographic, occupational and clinical factors associated with clinical worsening were gender, professional category, hypertension, diabetes mellitus, obesity, dyslipidemia, olfactory disorders, cough, fever, and dyspnea. The Poisson regression showed that the prevalence of clinical worsening was greater with age, obesity, fever, and dyspnea. Conclusion: Clinical wors-ening occurred in 3.4% of the cases and was more prevalent according to age, obesity, fever, and dyspnea. The follow-up has shown promise in the early detection and treatment of COVID-19 (AU).
Introdução: as estratégias de ação da atenção primária são relevantes para a prevenção de doenças e promoção da saúde, bem como para o manejo inicial de casos suspeitos e acompanhamento individual de pacientes com diagnóstico confirmado de COVID-19. Este estudo teve como objetivo avaliar o desfecho da piora clínica e variáveis demográficas, ocupacionais e clínicas de trabalhadores com COVID-19 em um centro comunitário de saúde de uma universidade pública do sudeste do Brasil. Métodos: estudo de coorte retrospectivo com 1.459 trabalhadores sin-tomáticos com COVID-19. Os dados foram extraídos do banco de dados do núcleo de vigilância epidemiológica da unidade entre março de 2020 e março de 2021. Resultados: A média de idade dos participantes foi de 41,1 (DP 10,8) anos, sendo a maioria mulheres (71,1%), com obesidade (19,9%) e hipertensão (17,0%). Dentre os sintomas, destacaram-se a cefaleia (75,3%) e a tosse (74,9%). A piora do quadro clínico durante o seguimento ocorreu em 3,4% dos casos. Os fatores demográficos, ocupacionais e clínicos associados à piora clínica foram sexo, categoria profissional, hipertensão arterial, diabetes mellitus, obesidade, dislipidemia, distúrbios do olfato, tosse, febre e dispneia. A regressão de Poisson mostrou que a prevalência de piora clínica foi maior com a idade, obesidade, febre e dispneia. Conclusão: A piora clínica ocorreu em 3,4% dos casos e foi mais prevalente conforme idade, obesidade, febre e dispneia. O acompanhamento mostrou-se promissor na detecção precoce e no tratamento da COVID-19 (AU).
Asunto(s)
Humanos , Atención Primaria de Salud , SARS-CoV-2 , COVID-19/epidemiologíaRESUMEN
OBJECTIVES: To verify the content validity of questions of an insulin adherence questionnaire based on the Theory Planned Behavior in outpatients with type 2 diabetes mellitus. METHODS: The instrument was derived from a tool created to evaluate psychosocial determinants of adherence to oral antidiabetics medications in the Brazilian context, and was submitted for evaluation by a committee of experts and members of the target population. The item-level content validity index, the scale-level content validity index averaging calculation method, and the modified kappa coefficient were used to evaluate agreement among specialists. The comprehensibility of the instrument by members of the target population was qualitatively analyzed. RESULTS: The item-level content validity index was found to be lower than desired in 6 of the 20 items analyzed. Of these, one item was modified and 5 were excluded after the comprehensibility evaluation by members of the target population; one item from the perceived control scale was excluded. Content validation resulted in an instrument with 14 items, distributed in the domains intention (4 items), attitude (3 items), perceived norm (4 items), and perceived control (4 items) scales. CONCLUSIONS: The findings support good evidence of the content validity of the instrument for use among people with type 2 diabetes mellitus receiving insulin therapy.