AIDS-related mortality in Pará Province, Brazilian Amazon region: Spatial and temporal analysis.

Despite considerable therapeutic advances in the care of people living with human immunodeficiency virus (HIV) and with the acquired immunodeficiency syndrome (AIDS) and an overall reduction of 47% in the AIDS mortality rate in the last decade, the AIDS-mortality rates remains high. The social determinants of health (SDH) have a direct influence on the dynamics of this phenomenon. However, changes in SDH caused by the implemented policies against HIV have been poorly investigated. Moreover, the Brazilian rainforest has had the highest and continuously increasing AIDS mortality rate in Brazil since the 1980s. In this study, AIDS mortality in a province of the Brazilian rainforest was examined by using temporal and spatial analyses. METHODS: In this ecological study, data from 2007 to 2018 were extracted from the Mortality Information System provided by the State Department of Public Health of Pará. For the temporal analysis, the integrated autoregressive model of moving average (ARIMA) and locally weighted polynomial regression (STLF) were used to forecast AIDS mortality from 2019 to 2022. For the spatial analysis, spatial autocorrelation and geographically weighted regression (GWR) analyses were employed. RESULTS: The samples consisted of 6,498 notifications for AIDS-related deaths. From 2007 to 2013, the AIDS mortality rates showed an upward trend, followed by a stabilization until 2018 and an upward forecasted trend from 2019 to 2022. High mortality rates and high-high clusters were found in economic pole municipalities. Furthermore, AIDS mortality risk was directly associated with per capita income and demographic density, except in the southwestern region of Pará, which exhibited an inverse association with population density. CONCLUSION: Although the policies against HIV may have contributed to the stabilization of AIDS mortality rates from 2013 in Pará, the upward forecasted trend until 2022 raises an alert and concern to health authorities to provide reinforcement of the policies. The geographic variability of AIDS mortality promoted by SDH provides subsidies to health authorities to implement SDH-focused strategies for AIDS mortality reduction.

The Family Health Strategy Influence on the Human Papillomavirus Vaccine Acceptance in a Peripheral Community of the Brazilian Amazon Region.

Introduction: The coverage of the human papillomavirus (HPV) vaccine remains low worldwide. The Family Health Strategy (FHS) in Brazil has an important role in health promotion in communities. Given the FHS's close contact with assisted communities, the coverage of the HPV vaccine should be high in children. This study aims to investigate the acceptance of the HPV vaccine of parents or guardians of a peripheral community of the Brazilian Amazon region assisted by the FHS and influencing factors. Methods: A cross-sectional community-based study recruiting the residents of a subnormal agglomerate of Belém (Pará-Brazil) and covered by the FHS was conducted. Data were collected from September 30 to November 5, 2019. The questionnaire "Knowledge and Acceptability of HPV and Its Vaccine" was used. Data were analyzed through binary and multiple regression analyses. Results: A total of 247 participants were included in this study, and 85 of which (34.4%) declared that they did not vaccinate their children. Hesitation to vaccinate was related to few years of schooling (odds ratio [OR]: 0.79, p=0.008), having sons (OR: 3.14, p=0.000), inadequate knowledge about doses of the HPV (OR: 2.44, p=0.015), and knowledge of anyone who received the HPV vaccine (OR: 7.07, p=0.000). Conclusion: Results suggested the low efficiency of FHS in increasing the HPV vaccination coverage in the assisted communities. A strategy involving a dialog with assisted families and continuous health education to health professionals should be implemented to combat fake news and increase HPV vaccination coverage.

Nursing process for elderly women susceptible to falls from the perspective of the Pender's Model.

OBJECTIVES: to describe the strategy of applying the nursing process guided by Pender's Health Promotion Model to elderly women susceptible to falls with a view to promoting a self-efficacy behavior for fall prevention. METHODS: application of the nursing process to eleven elderly women who had already experienced falls, living in a neighborhood in the outskirts of Belem, state of Pará, which involved interviews to obtain their nursing history and group meetings using the focus group technique to develop the other phases of the nursing process: nursing diagnosis, nursing interventions, and nursing assessment. RESULTS: despite the risk factors for falls, the intervention model adopted in this study allowed elderly women to enhance their self-efficacy. FINAL CONSIDERATIONS: the model proved to be suitable for the participation of elderly women in actions to build fall prevention behaviors, with a view to healthier lifestyles.

Nursing process for elderly women susceptible to falls from the perspective of the Pender's Model / Proceso de enfermería para ancianas susceptibles a caídas en la perspectiva del Modelo de Pender / Processo de Enfermagem para idosas suscetíveis a queda na perspectiva do Modelo de Pender

ABSTRACT Objectives: to describe the strategy of applying the nursing process guided by Pender's Health Promotion Model to elderly women susceptible to falls with a view to promoting a self-efficacy behavior for fall prevention. Methods: application of the nursing process to eleven elderly women who had already experienced falls, living in a neighborhood in the outskirts of Belem, state of Pará, which involved interviews to obtain their nursing history and group meetings using the focus group technique to develop the other phases of the nursing process: nursing diagnosis, nursing interventions, and nursing assessment. Results: despite the risk factors for falls, the intervention model adopted in this study allowed elderly women to enhance their self-efficacy. Final Considerations: the model proved to be suitable for the participation of elderly women in actions to build fall prevention behaviors, with a view to healthier lifestyles.

RESUMEN Objetivos: describir la estrategia de aplicar el proceso de enfermería orientado por el Modelo de Promoción de Salud de Pender a ancianas susceptibles a caídas, apuntando a un comportamiento auto eficaz en la prevención de caídas. Métodos: aplicación del proceso de enfermería en once ancianas que ya habían sufrido caídas, residentes en un barrio periférico de Belém, PA. Incluyó: entrevista para obtener el historial de enfermería; reuniones grupales, siguiendo la técnica del grupo focal para desarrollar las restantes fases del proceso de enfermería: diagnóstico de enfermería, intervenciones de enfermería, evaluación de enfermería. Resultados: a pesar de los factores de riesgo de caídas presentes, el Modelo de intervención adoptado permitió que las ancianas incrementaran su potencial de autoeficacia. Consideraciones Finales: el Modelo se mostró adecuado al protagonismo de las ancianas en acciones de construcción de comportamientos preventivos de caídas, con miras a estilos de vida más saludables.

RESUMO Objetivos: descrever a estratégia de aplicação do processo de enfermagem guiado pelo Modelo de Promoção de Saúde de Pender a idosas suscetíveis a queda com vistas ao comportamento auto eficaz de prevenção de quedas. Métodos: aplicação do processo de enfermagem a onze idosas que já haviam sofrido quedas, moradoras em bairro de periferia de Belém, PA, o qual envolveu entrevista para obter o histórico de enfermagem e reuniões grupais, seguindo a técnica do grupo focal para desenvolver as demais fases do processo de enfermagem: diagnóstico de enfermagem, intervenções de enfermagem, avaliação de enfermagem. Resultados: apesar dos fatores de risco presentes para quedas, o Modelo adotado de intervenção propiciou a idosas potencializarem seu poder de autoeficácia. Considerações Finais: o Modelo mostrou-se adequado ao protagonismo das idosas em ações na construção de comportamentos de prevenção de quedas, com vistas a estilos de vida mais saudáveis.

Factors associated with low knowledge about sexually transmitted infections in subnormal agglomerate, in the Brazilian Amazon.

BACKGROUND: Populations living in subnormal agglomerates in urban areas are more vulnerable to infections, including sexually transmitted infections (STIs). In these groups, inadequate knowledge about sexually transmitted infections can further increase the risk of contracting STIs. AIM: We investigated the factors associated with low knowledge about STIs in a peripheral population in the Brazilian Amazon. METHODS: This cross-sectional study was conducted in Belém, in the Amazon region that has a high percentage of subnormal agglomerates in an urban area and a high incidence of STIs. Random sampling was adopted which resulted in a sample of 320 participants. To assess knowledge about STIs, the self-administered Sexually Transmitted Disease Knowledge Questionnaire was used. To assess aspects of vulnerability, a questionnaire was constructed which is linked to individual, social, and programmatic factors. The chi-square test, G test, and ordinal regression analyses were all performed. FINDINGS: The sample of this study was composed of 320 participants. The mean age of the participants was 46.09 years. 37.5% (120), 50.6% (162), and 11.9% (38) showed low, medium, and high knowledge, respectively. Multiple analysis revealed that the factors associated with higher chance of having smaller knowledge about sexually transmitted infections were single/separated/divorced/widow(er) marital status (AOR: 1.80, CI: 1.15-2.84, P = 0.01); income equal to or less than one minimum wage (1.98, CI: 1.21-3.17, P = 0.00); equal to or over than 52 years old (AOR: 1.99, CI: 1.25-3.17, P = 0.00); lack of guidance by a health professional (AOR: 1.59, CI: 1.01-2.51, P = 0.04). Our results show that this community suffer from suboptimal levels of knowledge on STIs, which are linked to individual, social, and programmatic factors. Characterising the risk and vulnerabilities factors allows for carrying out appropriate interventions for populations living in subnormal agglomerates in urban area.

The HIV epidemic in Colombia: spatial and temporal trends analysis.

BACKGROUND: Colombia has the fourth highest incidence rate of HIV/AIDS among all Latin American countries and it has been increasing since the 1980s. However, the number of studies that addresses this trend is limited. Here, we employed spatial and temporal trend analyses to study the behaviour of the epidemic in the Colombian territory. METHODS: Our sample included 72,994 cases of HIV/AIDS and 21,898 AIDS-related deaths reported to the National Ministry of Health between 2008 and 2016. We employed the joinpoint regression model to analyse the annual HIV/AIDS incidence and AIDS mortality rates. In the spatial analysis, we used univariate autocorrelation techniques and the Kernel density estimator. RESULTS: While the HIV/AIDS incidence had an increasing trend in Colombia, the AIDS mortality rate was stable. HIV/AIDS incidence and AIDS mortality showed a downward trend in the 0-14 age group. An upward trend was observed for HIV/AIDS incidence in people older than 15 years and with the highest trend in the 65 years and above group. AIDS mortality showed an increasing trend among people aged 65 years or older. The comparison between the sexes showed an upward trend of HIV/AIDS incidence in all age groups and AIDS-mortality rates in 65 years and above in men, while in women, the incidence was upward among those aged 45 years and above, and concerning the AIDS-mortality rate in the 45-64 group. The high-high clusters of HIV/AIDS incidence and AIDS mortality were located in the Andean and Caribbean regions. CONCLUSION: Our study found an upward trend in HIV/AIDS incidence and a stable trend in the AIDS mortality rate in Colombia. The downward trend in HIV/AIDS incidence and AIDS mortality rate in the 0-14 age group reflects the downwards mother-to-child HIV transmission. The upward trend in HIV/AIDS incidence in older women and AIDS mortality in younger women rates, compared with men, may be due to late diagnosis and treatment. The Caribbean and the 'coffee belt' regions were the most impacted by the HIV epidemic, most likely due to sexual tourism. Our results provide crucial information that may help Colombian health authorities fight HIV transmission.

Qualidade de vida de idosos brasileiros e portugueses: uma análise comparativa / Análisis comparativo de la calidad de vida de los adultos mayores de Brasil y Portugal / Quality of Life in Older Adults in Brazil and Portugal: A Comparative Analysis

Introdução: A longevidade tornou-se uma das maiores conquistas da segunda metade do século XX. Objetivo: Comparar a qualidade de vida de idosos brasileiros e portugueses usuários da atenção primária à saúde. Materiais e Métodos: Estudo quantitativo, transversal e comparativo, aplicado a amostra probabilística englobando 294 idosos acompanhados pela Saúde da Família divididos em dois grupos: 130 idosos em Benevides/Brasil, e 164 em Coimbra/Portugal, no período de 2015-2017. A caracterização sociodemográfica e avaliação da qualidade de vida foram obtidos pelo instrumento World Health Organization Questionnaire of Quality of Life (WHOQOL-bref), consta de 26 questões divididas em quatro domínios: físico, psicológico, relações sociais e meio ambiente. Aplicado o Teste U de Mann-Whitney para análise estatística comparativa. Resultados: Nos grupos verificou-se predomínio do sexo feminino, casados, aposentados e com baixo grau de escolaridade (1 a 4 anos). A média da distribuição etária foi 70 anos para brasileiros e 76 anos para portugueses; na comparação da qualidade de vida, os idosos brasileiros obtiveram os melhores escores no domínio psicológico (79,1) enquanto portugueses tiveram melhor escore no domínio meio ambiente (65,6). Em Benevides o escore mais baixo foi o domínio meio ambiente (56,3) e, em Coimbra, o domínio com escore mais baixo foi o físico (60,7). Discussão: A qualidade de vida no envelhecimento é importante preditor para a preservação da autonomia do idoso. Conclusões: Estes resultados ampliam a concepção da importância da atenção integral no processo de envelhecimento com vista a proporcionar melhor qualidade de vida contribuindo para satisfazer as necessidades especificas da população idosa.

Introduction: Longevity is one of the greatest achievements in the last half of the 20th century. Objective: To compare the quality of life in older adults in Brazil and Portugal receiving primary health care. Materials and Methods: A comparative cross-sectional quantitative study was conducted with a probability sample of 294 older adults, who had been assisted with the Family Health strategy, being divided into two groups: 130 older adults living in Benevides, Brazil and 164 in Coimbra, Portugal during 2015 and 2017. The sociodemographic characterization and the quality of life assessment were determined through the WHO Quality of Life-BREF (WHOQOL-BREF), which consists of 26 questions assessing four domains: physical health, psychological health, social relationships and environment. The Mann-Whitney U test was applied for comparative statistical analysis. Results: There was a prevalence of married, retired women with a lower level of education (1 to 4 years) in the groups. The average age was 70 years in Brazil and 76 years in Portugal. In terms of quality of life, Brazilian older adults got better scores in the psychological health domain (79.1%) while Portuguese older adults scored best in the environmental domain (65.6%). The lowest scores were found in the environmental domain in Benevides (56.3%) and in the physical health domain in Coimbra (60.7%). Discussion: Quality of life in aging is a major predictor for the preservation of autonomy in older adults. Conclusion: These results help to broaden the importance of comprehensive care in the aging process to provide a better quality of life, which contributes to meeting the specific needs of older population.

Introducción: La longevidad se ha convertido en uno los mayores logros de la segunda mitad del siglo XX. Objetivo: Comparar la calidad de vida de los adultos mayores de Brasil y Portugal que reciben atención primaria de salud. Materiales y métodos: Se realizó un estudio cuantitativo transversal comparativo con una muestra probabilística de 294 adultos mayores que fueron acompañados por la estrategia de Salud Familiar y divididos en dos grupos: 130 adultos mayores ubicados en Benevides, Brasil y 164 en Coímbra, Portugal durante 2015 y 2017. La caracterización sociodemográfica y la evaluación de la calidad de vida se obtuvieron mediante el Cuestionario de Calidad de Vida de la Organización Mundial de la Salud (WHOQOL-BREF), que consta de 26 preguntas divididas en cuatro áreas: salud física, salud psicológica, relaciones sociales y ambiente. Se aplicó la prueba U de Mann-Whitney para el análisis estadístico comparativo. Resultados: En los grupos se observó el predominio de las mujeres casadas, jubiladas y con baja escolaridad (entre 1 y 4 años). La edad media fue de 70 años en Brasil y 76 años en Portugal. En cuanto a la calidad de vida, los adultos mayores brasileños obtuvieron mejores puntuaciones en el área de salud psicológica (79.1%) mientras que los adultos mayores portugueses tuvieron la mejor puntuación en el área ambiental (65.6%). Las puntuaciones más bajas se presentaron en el área ambiental en Benevides (56.3%) y en la salud física (60.7%) en Coímbra. Discusión: La calidad de vida en el proceso de envejecimiento es un importante predictor para la preservación de la autonomía de los adultos mayores. Conclusiones: Estos resultados amplían la concepción de la importancia de la atención integral en el proceso de envejecimiento para brindar una mejor calidad de vida, lo que contribuye a satisfacer las necesidades específicas de la población de edad avanzada.

Análise espaço-temporal da epidemia do HIV em idosos num estado amazônico brasileiro / Spatiotemporal analysis of the HIV epidemic in older people in a Brazilian Amazon state

Resumo Objetivo Analisar espaço-temporalmente a incidência do vírus da imunodeficiência humana (HIV) e da síndrome da imunodeficiência adquirida (Aids) entre idosos no estado do Pará, Brasil, nos anos de 2007 a 2018. Método Estudo ecológico utilizando notificações de casos de HIV/Aids em idosos provenientes do Sistema de Informação de Agravos de Notificação. A taxa de incidência do HIV/Aids foi analisada temporalmente pelo método de joinpoint e espacialmente pelas técnicas de autocorrelação de Moran, de varredura e de regressão espacial. Resultados 2.639 notificações de HIV/Aids foram elegíveis para o estudo, sendo 1.725 (65,4%) em homens e 914 (34,6%) em mulheres. No período do estudo houve aumento de 2.422,5% na taxa de incidência de HIV nos homens e de 1.929,8% nas mulheres, sendo o oposto, observado para a taxa de incidência de Aids que aumentou 77,6% nas mulheres e 40,7% nos homens. O método joinpoint revelou tendência crescente para a taxa de incidência de HIV (APC=30%, p=0,00) e de estabilidade para taxa de incidência de Aids (APC=3,0%, p=0,2). Os municípios mais impactados pela epidemia do HIV foram os do meridional sudeste paraense com moderada associação (R2=0,65) ao seu crescimento populacional. A análise de varredura espaço-temporal apontou Belém como zona de risco para o HIV/Aids (RR=3,93, p=0,00; 2017-2018) Conclusão Enquanto a incidência de Aids em idosos paraenses permaneceu estável no período de 2007 a 2018, a de HIV tendeu a crescer. O maior impacto da epidemia ocorreu nos municípios do sudeste paraense com associação ao crescimento populacional, e Belém apresentou risco espaço-temporal para o HIV/Aids.

Abstract Objective To analyze spatiotemporally the incidence of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) among older people in the State of Pará, Brazil, from 2007 to 2018. Method An ecological study of HIV/AIDS case notifications in older people from the Brazilian Information System on Notifiable Diseases. The HIV/AIDS incidence rate was temporally analyzed by the joinpoint method, and spatially by the Moran autocorrelation of scanning and spatial regression techniques. Results 2,639 notifications of HIV/AIDS were eligible for the study, with 1,725 (65.4%) being in men and 914 (34.6%) in women. During the study period, there was an increase of 2,422.5% in the HIV incidence rate in men and 1,929.8% in women, with the opposite being observed for the AIDS incidence rate, which increased 77.6% in women and 40.7% in men. The joinpoint method showed an increasing trend for the HIV incidence rate (APC=30%, p=0.00) and stability for the AIDS incidence rate (APC=3.0%, p=0.2). The most impacted municipalities by the HIV epidemic were those in the south-eastern part of Pará, with a moderate association (R2=0.65) with its population growth. The spatiotemporal scanning analysis pointed to Belém as a risk zone for HIV/AIDS (RR=3.93, p=0.00; 2017-2018). Conclusion While the incidence of AIDS among older people from Pará remained stable from 2007 to 2018, that of HIV tended to grow. The greatest impact of the epidemic occurred in southeastern Pará municipalities, and it was associated with the population growth; Belém presented a spatiotemporal risk for HIV/AIDS.

Correlation between functional independence and risk of falls in older adults at three long-term care facilities. / Correlação entre independência funcional e risco de quedas em idosos de três instituições de longa permanência.

OBJECTIVE: To verify the correlation between functional independence and the risk of falls in a group of institutionalized older adults. METHOD: A cross-sectional, observational, quantitative study conducted in three Long-Term Care Facilities for older adults in the Municipality of Belém, involving both genders and assessed using the Katz Index and Tinetti Index. Pearson's Chi-squared test was used for analysis, adopting a p-value significance level of < 0.05. The data correlation was performed using the Pearson correlation test with a significance of 5% (p<0.05). RESULTS: Forty-eight (48) older adults participated. Most were classified as functionally independent (89.6%) and with a low risk of falls (58.3%). There was a moderate correlation between functional independence and low risk of falls. CONCLUSION: The more independent the older adult is, the lower the risk of falls. Therefore, it is necessary to plan individualized care, considering its peculiarities and limitations, so that older adults can preserve their functional independence for longer.

The association between knowledge about HIV and risk factors in young Amazon people.

OBJECTIVES: analyze the association between the level of HIV knowledge among young people from Amazonas region, their sociodemographic profile and infection risk factors. METHODS: cross-sectional analytical study, which used a structured questionnaire containing questions about sociodemographic, behavioral aspects and HIV knowledge. Data were grouped by sex and underwent ordinal and binary logistic regression analysis. RESULTS: the students had an HIV knowledge deficit, associated with a low educational level of their parents and low family income. The most frequent risk factors were lack of knowledge on the part of female students regarding proper male condom use, their infrequent use in sexual relations and failure to do HIV testing. There was an association between level of knowledge and use of dating apps by female students. CONCLUSIONS: there was no association between level of knowledge and the preponderant risk factors, but the students' knowledge deficit rendered them more vulnerable to infection.

Conhecimento e atitude sobre diabetes mellitus de usuários idosos com a doença atendidos em unidade básica de saúde / Knowledge and attitude about diabetes mellitus of elderly with the disease attended at a basic health unit / Conocimiento y actitud sobre diabetes mellitus de ancianos con la enfermedad atendidos en una unidad básica de salud

Objetivo: Descrever o conhecimento e atitude dos portadores de Diabetes Mellitus do Programa Idoso da Unidade de Saúde de Marambaia, Belém-PA, acerca da própria doença. Método: estudo descritivo realizado com 50 idosos aplicando-lhes: formulário de dados sociodemográficos e de saúde; questionários, de origem holandesa: Diabetes Knowledge e Diabetes Attitude Questionnaire sobre DM, traduzidos e validados para o português do Brasil. Resultados: Dos idosos estudados, a maioria era de mulheres (72%); média de idade de 71 anos; escolaridade entre 1 e 4 anos (48%). A avaliação do conhecimento, com escore baixo obtido, representava conhecimento insuficiente para compreensão da doença e para práticas de autocuidado. Quanto à atitude, também obteve escore negativo indicando baixa aceitação da própria doença. Conclusão: A constatação de baixo nível de conhecimento e de atitude negativa em relação a DM, denota sério comprometimento dos idosos na adesão ao tratamento e elevação de taxas de complicação associada à DM.(AU)

Objective: To describe the knowledge and attitude of patients with Diabetes Mellitus of the Elderly Program of the Health Unit of Marambaia, Belém-PA, about the disease itself. Method: a descriptive study with 50 elderly people applying them: sociodemographic and health data form; Dutch questionnaires: Diabetes Knowledge and Diabetes Attitude Questionnaire on DM, translated and validated into Brazilian Portuguese. Results: Of the elderly studied, the majority were women (72%); mean age of 71 years; between 1 and 4 years (48%). Knowledge assessment, with low score obtained, represented insufficient knowledge for understanding the disease and for self-care practices. As for the attitude, also obtained negative score indicating low acceptance of the disease itself. Conclusion: The finding of low level of knowledge and negative attitude regarding the elderly DM indicates a serious commitment to treatment adherence and increased complication rates associated with DM.(AU)

Objetivo: Describir conocimiento y actitud de los portadores de Diabetes Mellitus del Programa Anciano de la Unidad de Salud de Marambaia, Belém-PA, acerca de la propia enfermedad. Método: estúdio descriptivo realizado con 50 ancianos aplicándoles: forma de datos sociodemográficos y de salud; cuestionarios, de origen holandés: La diabetes y el Conocimiento de la Diabetes Attitude Cuestionario sobre DM, traducidos y validados para el portugués de Brasil. Resultados: De los ancianos estudiados, la mayoría eran mujeres (72%); promedio de edad de 71 años; escolaridad entre 1 y 4 años (48%). La evaluación del conocimiento, com escasa baja obtenida, representaba conocimiento insuficiente para la comprensión de la enfermedad y para las prácticas de autocuidado. Encuanto a la actitud, también obtuvo puntuación negativa indicando baja aceptación de la propia enfermedad. Conclusión: La constatación de bajo nivel de conocimiento y de actitud negativa em relación a DM de los ancianos, denota seria lacuna de compromiso de adhesión al tratamiento y elevación de tasas de complicación asociada a la DM.(AU)

Correlação entre independência funcional e risco de quedas em idosos de três instituições de longa permanência / Correlación entre la independencia funcional y el riesgo de caídas en los ancianos en tres instituciones de larga permanencia / Correlation between functional independence and risk of falls in older adults at three long-term care facilities

RESUMO Objetivo Verificar a correlação entre a independência funcional e o risco de quedas em um grupo de idosos institucionalizados. Método Estudo transversal, observacional, quantitativo, realizado em três Instituições de Longa Permanência para Idosos no Município de Belém, de ambos os gêneros, avaliados por meio do Índice de Katz e Índice de Tinetti. Para análise utilizou-se o teste de Qui-quadrado de Pearson, adotando-se um nível de significância de p-valor < 0.05. E a correlação dos dados foi realizada pelo teste de correlação de Pearson, com significância de 5% (p<0,05). Resultados Participaram 48 idosos. A maioria foi classificada como funcionalmente independente (89,6%) e com baixo risco de quedas (58,3%). Houve correlação moderada entre a independência funcional e baixo riscos de quedas. Conclusão Quanto mais independentes são os idosos, menor é o risco de quedas. Portanto, é necessário fazer um planejamento de cuidados individualizados, considerando suas peculiaridades e limitações, de modo que o idoso possa preservar por mais tempo sua independência funcional.

RESUMEN Objetivo Comprobar la correlación entre la independencia funcional y el riesgo de caídas en un grupo de ancianos institucionalizados. Método Estudio transversal, observacional, cuantitativo, realizado en tres Instituciones de Larga Permanencia para Ancianos en el municipio de Belém, de los dos géneros, evaluados por medio del Índice de Katz y del Índice de Tinetti. Para análisis fue utilizado el test de Qui-quadrado de Pearson, adoptando un nivel de significado de p-valor < 0.05. Y la correlación de los datos fue realizada por el test de correlación de Pearson, con significado de 5% (p<0,05). Resultados Participaron 48 ancianos. La mayoría fue clasificada como funcionalmente independiente (89,6%) y con bajo riesgo de caídas (58,3%). Hube correlación moderada entre la independencia funcional y bajo riesgo de caídas. Conclusión Cuanto más independientes son los ancianos, menor es lo riesgo de caídas. Entonces, es necesario hacer um planeamiento de cuidados individualizados, considerando sus peculiaridades y limitaciones, para que el anciano pueda preservar por más tiempo su independencia funcional.

ABSTRACT Objective To verify the correlation between functional independence and the risk of falls in a group of institutionalized older adults. Method A cross-sectional, observational, quantitative study conducted in three Long-Term Care Facilities for older adults in the Municipality of Belém, involving both genders and assessed using the Katz Index and Tinetti Index. Pearson's Chi-squared test was used for analysis, adopting a p-value significance level of < 0.05. The data correlation was performed using the Pearson correlation test with a significance of 5% (p<0.05). Results Forty-eight (48) older adults participated. Most were classified as functionally independent (89.6%) and with a low risk of falls (58.3%). There was a moderate correlation between functional independence and low risk of falls. Conclusion The more independent the older adult is, the lower the risk of falls. Therefore, it is necessary to plan individualized care, considering its peculiarities and limitations, so that older adults can preserve their functional independence for longer.

The association between knowledge about HIV and risk factors in young Amazon people / Asociación entre conocimiento sobre VIH y factores de riesgo em los jóvenes de la Amazonia / Associação entre conhecimento sobre HIV e fatores de risco em jovens amazônidas

ABSTRACT Objectives: analyze the association between the level of HIV knowledge among young people from Amazonas region, their sociodemographic profile and infection risk factors. Methods: cross-sectional analytical study, which used a structured questionnaire containing questions about sociodemographic, behavioral aspects and HIV knowledge. Data were grouped by sex and underwent ordinal and binary logistic regression analysis. Results: the students had an HIV knowledge deficit, associated with a low educational level of their parents and low family income. The most frequent risk factors were lack of knowledge on the part of female students regarding proper male condom use, their infrequent use in sexual relations and failure to do HIV testing. There was an association between level of knowledge and use of dating apps by female students. Conclusions: there was no association between level of knowledge and the preponderant risk factors, but the students' knowledge deficit rendered them more vulnerable to infection.

RESUMEN Objetivos: analizar la asociación entre nivel de conocimiento sobre VIH de jóvenes de la Amazonia, perfil sociodemográfico y factores de riesgo para la infección. Métodos: estudio tipo survey analítico transversal, aplicando cuestionario estructurado, incluyéndose preguntas sociodemográficas y de conocimiento sobre VIH. Datos agrupados por sexo, sometidos a análisis de regresión logística ordinal y binaria. Resultados: los estudiantes tenían déficit de conocimiento sobre VIH, asociado a baja escolarización parental e ingreso familiar escaso. Los factores de riesgo más frecuentes fueron: desconocimiento del correcto uso del preservativo masculino por parte de las alumnas, infrecuencia de su uso en las relaciones sexuales de todos los estudiantes, y no realizar análisis de VIH. Existió asociación entre nivel de conocimiento y uso de aplicaciones de citas entre las alumnas. Conclusiones: no hubo asociación entre nivel de conocimiento y factores de riesgo preponderantes, aunque el bajo conocimiento de los estudiantes los hace más vulnerables a infectarse.

RESUMO Objetivos: analisar a associação entre o nível de conhecimento sobre o HIV de jovens amazônidas e o perfil sociodemográfico e fatores de risco para a infecção. Métodos: estudo tipo survey analítico transversal empregando questionário estruturado contendo questões sociodemográficas, comportamentais e de conhecimento sobre o HIV. Os dados foram agrupados por sexo e submetidos à análise de regressão logística ordinal e binária. Resultados: os estudantes possuíam déficit de conhecimento sobre o HIV, associado à baixa escolaridade dos pais e à baixa renda familiar. Os fatores de risco mais frequentes foram: desconhecimento do uso correto do preservativo masculino pelas alunas, seu uso infrequente nas relações sexuais pelos estudantes e não testagem anti-HIV. Houve associação entre nível de conhecimento e uso de aplicativos de encontro pelas alunas. Conclusões: não houve associação entre nível de conhecimento e fatores de risco preponderantes, porém, o déficit de conhecimento dos estudantes torna-os mais vulneráveis à infecção.

Functional capacity assessment of long-lived older adults from Amazonas.

OBJECTIVE: To evaluate the functional capacity of long-lived older adults from Amazonas. METHOD: A cross-sectional epidemiological study was carried out with 116 older adults aged 80 years or older, registered in a primary health care unit in Belém, in the state of Pará, Brazil. The Functional Independence Measure (FIM) was used for functional capacity assessment and the Mini-Mental State Examination (MMSE) for cognitive screening. Univariate and bivariate analyses were carried out, in addition to the Pearson's chi-square test. RESULTS: The older adults presented modified independence in the self-care, sphincter control and locomotion dimensions, and needed supervision for mobility/transfers. In mobility, men presented complete independence. Modified independence was found in the 80-89 age group. It was observed that, the lower the education level, the worse the cognitive performance. CONCLUSION: In spite of their advanced age, long-lived older adults still present functional capacity for activities of daily living, even though they required supervision for high energy expenditure tasks, such as mobility and transfers.

Rede de atenção: fragilidades no processo de implementação na perspectiva de especialistas em gestão da atenção primária / Care network: the implementation process from professionals' perspective specialized in primary health care management

Objetivo: Conhecer, da perspectiva de profissionais capacitados em gestão de Atenção Primária em Saúde, fragilidades relacionadas aos atributos e elementos necessários à implementação de uma Rede de Atenção às Condições Crônicas na Região Metropolitana III, no Pará. Metodologia: Pesquisa exploratório-descritiva, qualitativa, cujos dados foram colhidos por entrevista semiestruturada com 23 profissionais. A análise de conteúdo dos dados foi fundamentada nos preceitos organizativos da Rede de Atenção à Saúde. Resultados: Os profissionais alegaram fragilidades quanto aos atributos e elementos estruturais de atenção básica: falta de mecanismos de coordenação de cuidados, sistema de governança inoperante, estrutura operacional sem fluxos, déficit de insumos e de material, acesso precário no território, característica marcante na Região Norte. Conclusão: Constatam-se fragilidades na atenção básica e no sistema de governança, a falta de planejamento e pactuações. Urge estabelecer estratégias, planejamento e diálogo entre gestores de saúde da região, incluindo responsabilização dos serviços da rede e profissionais. (AU)

Objective: To know, from the perspective of professionals trained in Primary Health Care management, weaknesses related to the attributes and elements necessary for the implementation of a Network of Attention to Chronic Conditions in the Metropolitan Region III, Pará. Methodology: Exploratory-Descriptive, Qualitative Research , the data collected by semi-structured interview of 23 professionals. The analysis of the content of the data was based on the organizational precepts of the Health Care Network. Results: The professionals claimed fragilities regarding attributes and structural elements of basic care: lack of coordination mechanisms for care, inoperative governance system, operational structure without flows, input and material deficits, precarious access in the territory, a striking feature in the Northern Region. Conclusion: We note weaknesses in basic care and in the governance system, the lack of planning and pacts. It is imperative to establish strategies, planning and dialogue among health managers in the region, including the accountability of network services and professionals. (AU)

Objetivo: Conocer, desde la perspectiva de profesionales capacitados en gestión de Atención Primaria en Salud, fragilidades relacionadas a los atributos y elementos necesarios para la implementación de una Red de Atención a las Condiciones Crónicas en la Región Metropolitana III, en Pará. Metodología: Investigación exploratoria-descriptiva, cualitativa , los datos recogidos por entrevista semiestructurada, de 23 profesionales. El análisis del contenido de los datos fue fundamentado en los preceptos organizativos de la Red de Atención a la Salud. Resultados: Los profesionales alegaron fragilidades en cuanto a los atributos y elementos estructurales de atención básica: falta de mecanismos de coordinación de cuidados, sistema de gobernanza inoperante, estructura operativa sin flujos, déficit de insumos y de material, acceso precario en el territorio, característica marcante en la Región Norte. Conclusión: Se constata a las fragilidades en la atención básica y en el sistema de gobernanza, la falta de planificación y pactos. Es urgente establecer estrategias, planificación y diálogo entre gestores de salud de la región, incluyendo responsabilización de los servicios de la red y profesionales. (AU)

Functional capacity assessment of long-lived older adults from Amazonas / Evaluación de la capacidad funcional de ancianos longevos amazónicos / Avaliação da capacidade funcional de idosos longevos amazônidas

ABSTRACT Objective: To evaluate the functional capacity of long-lived older adults from Amazonas. Method: A cross-sectional epidemiological study was carried out with 116 older adults aged 80 years or older, registered in a primary health care unit in Belém, in the state of Pará, Brazil. The Functional Independence Measure (FIM) was used for functional capacity assessment and the Mini-Mental State Examination (MMSE) for cognitive screening. Univariate and bivariate analyses were carried out, in addition to the Pearson's chi-square test. Results: The older adults presented modified independence in the self-care, sphincter control and locomotion dimensions, and needed supervision for mobility/transfers. In mobility, men presented complete independence. Modified independence was found in the 80-89 age group. It was observed that, the lower the education level, the worse the cognitive performance. Conclusion: In spite of their advanced age, long-lived older adults still present functional capacity for activities of daily living, even though they required supervision for high energy expenditure tasks, such as mobility and transfers.

RESUMEN Objetivo: Evaluar la capacidad funcional de ancianos longevos amazónicos. Método: Estudio epidemiológico, transversal, realizado con 116 ancianos de edad igual o mayor a 80 años, registrados en una Unidad Municipal de Salud de Belém-Pará, Brasil. Para evaluar la capacidad funcional se utilizó la Medida de Independencia Funcional (MIF), y para la evaluación cognitiva, el Miniexamen del Estado Mental. Se aplicó análisis univariado y bivariado, además del test de Chi-cuadrado de Pearson. Resultados: Los ancianos mostraron independencia modificada en los dominios autocuidado, control de esfínteres, locomoción y supervisión de la movilidad/transferencia. En la movilidad, los hombres demostraron independencia total. En la faja etaria de 80-89 años se observó independencia modificada. Se notó que los menos escolarizados tenían peor desempeño cognitivo. Conclusión: A pesar de su edad, los longevos presentan aún capacidad funcional para su día a día, precisando supervisión para las tareas de mayor gasto energético, como movilidad y transferencia.

RESUMO Objetivo: Avaliar a capacidade funcional de idosos longevos amazônidas. Método: Estudo epidemiológico, transversal, realizado com 116 idosos com idade igual ou superior a 80 anos, cadastrados em uma Unidade Municipal de Saúde em Belém-Pará, Brasil. Para avaliação da capacidade funcional, utilizou-se a Medida de Independência Funcional (MIF) e, para rastreio cognitivo, o Mini-Exame do Estado Mental. Realizou-se a análise univariada e bivariada, além do teste Qui-Quadrado de Pearson. Resultados: Os idosos apresentaram independência modificada nos domínios autocuidado, controle de esfíncteres, locomoção e supervisão na mobilidade/transferência. Na mobilidade, os homens apresentaram independência total. Na faixa etária de 80 a 89 anos, observou-se independência modificada. Notou-se que quanto menor a escolaridade, pior o desempenho cognitivo. Conclusão: Apesar da idade avançada, os longevos ainda apresentaram capacidade funcional para o cotidiano, mesmo que necessitassem de supervisão para as tarefas de maior gasto energético como a mobilidade e transferência.

Avaliação de unidades familiares não tradicionais e suas implicações para o cuidado de enfermagem / Assessment of non-traditional family units and implications for nursing care

Unidades familiares não tradicionais logram conquistas contemporaneamente, tornando relevante a pesquisa acerca de seus aspectos estruturais e funcionais. Objetivou-se conhecer algumas famílias de configuração não tradicional, avaliando-as por intermédio do Modelo Calgary de Avaliação de Famílias. Procedeu-se estudo de caso qualitativo, realizado em Belém, PA, Brasil. A coleta de dados ocorreu entre novembro de 2017 até março de 2018 preferencialmente na presença da totalidade dos componentes em visitas domiciliares, com aplicação de entrevista semiestruturada conforme o diagrama ramificado do Modelo Calgary de Avaliação de Famílias e uso do software GenoPro. A classificação foi: unipessoal, uniparental feminina com filhos, homoafetiva feminina, tradicional com membro agregado e uniparental feminina com filho adotivo, indicando complexas relações com os componentes da unidade e da família extensa. O Modelo Calgary de Avaliação de Famílias demonstrou seu impacto para a enfermagem de família no que concerne à tipificação de famílias não tradicionais, assistência, expressão de sentimentos, solução de problemas e evolução dos arranjos familiares.

Non-traditional family units are gaining ground nowadays and research, therefore, on their structural and functional aspects is relevant. This qualitative case study, conducted in Belém, PA, Brazil, sought to explore some families with a non-traditional configuration, assessing them through the Calgary Family Assessment Model. The data was collected from November 2017 to March 2018 via home visits with preferably all the components present, using a semi-structured interview, according to the Calgary Family Assessment Model branching diagram, and GenoPro software. The classifications were: single-member, female single-parent with children, female homosexual, traditional with added member and female single-parent with an adopted child, indicating complex relationships among the components of the unit and with the extended family. The Calgary Family Assessment Model demonstrated their impact on family nursing in terms of the typification of non-traditional families, care, expression of feelings, solution of problems and evolution of family arrangements.

Photovoice como método de pesquisa para educação em saúde: uma revisão integrativa / Photovoice as a research method in health education: an integrative review

Photovoice é um método de pesquisa onde o participante registra por fotografia suas experiências, analisadas em ciclos de reflexão, avaliação e ação. Objetivou-se analisar publicações que relatem a utilização de photovoice por enfermeiros na educação para saúde. Procedeu-se a uma revisão integrativa da literatura nas bases de dados Medline® CINAHL®, LILACS®, SCOPUS, IBECS, BDENF, CAPES. Foram selecionados 27 estudos, publicados entre 2007 e 2018, identificando-se duas áreas temáticas: Transição saúde-doença e Criação de ambientes favoráveis à saúde. Estudos trouxeram subsídios norteadores de pesquisa em educação para a saúde usando photovoice, tanto para compreender e atuar em diferentes circunstâncias do processo saúde-doença quanto para criar estratégias educacionais favoráveis a ambientes saudáveis. Escassa produção dos enfermeiros brasileiros acerca de photovoice demonstra o desconhecimento das amplas possibilidades do método nas pesquisas de enfermagem, motivando-nos a enfatizar a necessidade de divulgá-la entre os pesquisadores da enfermagem, destacando seus úteis recursos investigativos.

Photovoice is a research method in which participants register their experiences as photographs and analyze them in reflection, evaluation, and action cycles. The objective of the present study was to examine publications that report the use of photovoice by nurses in health education. An integrative literature review was carried out by searching and analyzing data available in the following databases: the Medical Literature Analysis and Retrieval System Online, the Cumulative Index to Nursing and Allied Health Literature, the Latin America and Caribbean Center of Health Science Information, Scopus, Índice Bibliográfico Español en Ciencias de la Salud, Banco de Dados em Enfermagem, and the Coordination for Improvement of Higher Education Personnel. Twenty-seven studies published between 2007 and 2018 were selected, in which two subject areas were identified: health-illness transition and creation of health-enabling environments. The studies have guiding resources for research in health education using photovoice, both to understand and act in different circumstances of the health-illness process and to develop educational strategies that enable healthy environments. A scarce production by Brazilian nurses on photovoice shows the lack of knowledge of the possibilities the method offers in nursing studies, which encourages the authors of the present study to emphasize the need to disseminate it among nursing researchers, stressing its useful research features.