Ocorrência e fatores associados para infecção de sítio cirúrgico em colecistectomia videolaparoscópica / Occurrence of surgical site infection and associated factors in videolaparoscopic cholecystectomy

Objetivo: identificar ocorrência e fatores de risco relacionados à infecção de sítio cirúrgico em pacientes submetidos à colecistectomia videolaparoscópica. Métodos: estudo descritivo, realizado em hospital privado, com inclusão de 118 pacientes. Para coleta de dados, elaborou-se instrumento submetido à validação de face e conteúdo. Análise dos dados realizada pelo software Statistical Package Social Sciences. Resultados: ocorrência de infecção de 5,9% (n=7), cujos casos foram diagnosticados na vigilância pós-alta. Os resultados não apresentaram diferença estatisticamente significante entre as variáveis investigadas e a presença de infecção de sítio cirúrgico (análise bivariada). Conclusão: na instituição de saúde estudada, a ocorrência de infecção de sítio cirúrgico se mostrou elevada, não houve associação entre os fatores investigados e a presença deste tipo de infecção. (AU)

Intervenção antibullying proposta por enfermeiros: elaboração e validação pelo método Delphi / Program of intervention antibullying developed by nurses: proposal and validation through the Delphi method

Este estudo objetivou descrever a validação de conteúdo de uma intervenção antibullying a ser desenvolvida por enfermeiros no contexto escolar. O Programa de Intervenção e Educação em Saúde Antibullying (PIESA) foi elaborado com base em evidências presentes na literatura nacional e internacional. O método Delphi foi empregado para a validação do programa. Participaram da validação 11 enfermeiros especialistas em violência escolar e bullying. Os resultados indicaram que na primeira rodada os especialistas apresentaram 100% de consenso para a maioria dos domínios e recomendações que compunham o PIESA. Mesmo o domínio referente à participação do enfermeiro no planejamento escolar, que obteve concordância parcial, ficou acima de 80% de consenso. Conclui-se que o programa proposto abrange as possibilidades de atuação do enfermeiro na prevenção e enfrentamento do bullying escolar.(AU)

The aim of this study was to describe content validation of an anti-bullying intervention to be conducted by nurses within the school context. The Anti-bullying Health Intervention and Education Program (AHIEP) was elaborated considering evidences from national and international literature. The Delphi method was used to validate the program. A total of 11 nurses specialized on school violence and bullying participated on the study. The results indicated that at the first round the specialists agreed on 100% to the majority of the domains and recommendations that formed the AHIEP. Even the domain concerning the participation of the nurse at the school's planning, which presented partial agreement, was above 80% agreement between the specialists. It is possible to conclude that the proposed program covers the possibilities of action of the nurse to prevent and confront bullying in a school environment.(AU)

Interações familiares de estudantes em situações de bullying / Family interactions of students in bullying situations

RESUMO Objetivo Analisar a qualidade das interações familiares de adolescentes e o envolvimento em situações de bullying escolar. Métodos Estudo transversal de base populacional que contou com a participação de 2.354 estudantes (meninas = 50,7%; idade média M = 14,5 anos, DP = 2,0 anos) do ensino fundamental e médio, de 11 escolas públicas de uma cidade do interior de Minas Gerais. A amostra do estudo foi definida pela seleção de estratos (escolas), utilizando o método Probability Proportional to Size. A coleta de dados ocorreu por meio da aplicação coletiva de duas escalas, sendo uma para identificar comportamentos de bullying/vitimização e outra para aferir a qualidade das interações familiares dos adolescentes. Os procedimentos de análise incluíram: análise estatística descritiva, análise de variância (ANOVA) e regressão logística. Resultados O estudo identificou uma prevalência de 10,3% de estudantes agressores, 10,1% de vítimas e 5,4% de vítimas-agressoras na amostra. Verificou-se que os estudantes não envolvidos em situações de bullying possuíam melhores interações familiares quando comparados com os estudantes identificados como agressores, vítimas e vítimas-agressoras. Efeitos do aspecto "regras e monitoria" (OR: 1,21; p = 0,001) no contexto familiar foram identificados como protetivo para o bullying ou a vitimização. Os aspectos "punição física" (OR: 0,84; p = 0,001) e "comunicação negativa" (OR: 0,53; p = 0,001) foram associados a maior possibilidade de bullying ou vitimização entre os estudantes. Conclusões Confirmou-se que a qualidade das interações familiares influencia no envolvimento dos estudantes em situações de bullying. Implicações para a área da saúde foram discutidas a partir de indicadores de risco e proteção identificados.

ABSTRACT Objective To analyze the quality of the family interactions of adolescents and the involvement in situations of school bullying. Methods A population-based cross-sectional study involving 2,354 students (girls = 50.7%, mean age M = 14.5 years, SD = 2.0 years) of 11 primary schools in a city of the interior of Minas Gerais. The study sample was defined by stratum selection (schools), using the Probability Proportional to Size method. The data collection occurred through collective application of two scales, one to identify behaviors of bullying/victimization and another to measure the quality of family interactions of the adolescents. The analysis procedures included: descriptive statistical analysis, analysis of variance (ANOVA) and logistic regression. Results The study found a prevalence of 10.3% of the aggressors students, 10.1% of the victims and 5.4% of the victims-aggressors in the sample. It was found that students not involved in bullying situations had better family interactions when compared to students identified as aggressors, victims and victims-aggressors. Effects of the "rules and monitoring" aspect (OR: 1,21; p = 0,001) in the family context were identified as protective for bullying or victimization. The "physical punishment" (OR: 0,84, p = 0,001) and "negative communication" (OR: 0,53; p = 0,001) aspects were associated with a greater possibility of bullying or victimization among the students. Conclusions It was confirmed that the quality of family interactions influences the involvement of the students in bullying situations. Implications for the health area were discussed from identified risk and protection indicators.

General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil.

People who use drugs are continuously subjected to harsh stigmatization through a process of relational and social degradation, which limits their possibility for recovery. This quantitative study explores the perspectives of family members or significant others of illicit drug users, regarding general beliefs about illicit drug use and their stigma. Respondents agree that most people do not trust people who use drugs, disregard individuals who have been hospitalized due to drug problems and do not think people who use drugs are as intelligent as the general population. These findings reveal a high level of public stigma regarding illicit drug use.

Validity and reliability of the Questionnaire for Compliance with Standard Precaution.

OBJECTIVE: To evaluate the validity and reliability of the Questionnaire for Compliance with Standard Precaution for nurses. METHODS: This methodological study was conducted with 121 nurses from health care facilities in Sao Paulo's countryside, who were represented by two high-complexity and by three average-complexity health care facilities. Internal consistency was calculated using Cronbach's alpha and stability was calculated by the intraclass correlation coefficient, through test-retest. Convergent, discriminant, and known-groups construct validity techniques were conducted. RESULTS: The questionnaire was found to be reliable (Cronbach's alpha: 0.80; intraclass correlation coefficient: (0.97) In regards to the convergent and discriminant construct validity, strong correlation was found between compliance to standard precautions, the perception of a safe environment, and the smaller perception of obstacles to follow such precautions (r = 0.614 and r = 0.537, respectively). The nurses who were trained on the standard precautions and worked on the health care facilities of higher complexity were shown to comply more (p = 0.028 and p = 0.006, respectively). CONCLUSIONS: The Brazilian version of the Questionnaire for Compliance with Standard Precaution was shown to be valid and reliable. Further investigation must be conducted with nurse samples that are more representative of the Brazilian reality. The use of the questionnaire may support the creation of educational measures considering the possible gaps that can be identified, focusing on the workers' health and on the patients' safety.

Validity and reliability of the questionnaire for compliance with standard precaution / Validade e confiabilidade do questionário de adesão às precauções-padrão

ABSTRACT OBJECTIVE : To evaluate the validity and reliability of the Questionnaire for Compliance with Standard Precaution for nurses. METHODS : This methodological study was conducted with 121 nurses from health care facilities in Sao Paulo's countryside, who were represented by two high-complexity and by three average-complexity health care facilities. Internal consistency was calculated using Cronbach's alpha and stability was calculated by the intraclass correlation coefficient, through test-retest. Convergent, discriminant, and known-groups construct validity techniques were conducted. RESULTS : The questionnaire was found to be reliable (Cronbach's alpha: 0.80; intraclass correlation coefficient: (0.97) In regards to the convergent and discriminant construct validity, strong correlation was found between compliance to standard precautions, the perception of a safe environment, and the smaller perception of obstacles to follow such precautions (r = 0.614 and r = 0.537, respectively). The nurses who were trained on the standard precautions and worked on the health care facilities of higher complexity were shown to comply more (p = 0.028 and p = 0.006, respectively). CONCLUSIONS : The Brazilian version of the Questionnaire for Compliance with Standard Precaution was shown to be valid and reliable. Further investigation must be conducted with nurse samples that are more representative of the Brazilian reality. The use of the questionnaire may support the creation of educational measures considering the possible gaps that can be identified, focusing on the workers' health and on the patients' safety.

RESUMO OBJETIVO : Avaliar a validade e a confiabilidade do Questionário de Adesão às Precauções-padrão em enfermeiros. MÉTODOS : Estudo metodológico realizado com 121 enfermeiros de estabelecimentos de saúde do interior de São Paulo, 2012, representados por dois estabelecimentos de alta complexidade e três de média complexidade. A consistência interna foi calculada pelo alfa de Cronbach e a estabilidade pelo coeficiente de correlação intraclasse, por meio de teste-reteste. Foi realizada a validação de construto convergente, divergente e por grupos conhecidos. RESULTADOS: O questionário mostrou-se confiável (alfa de Cronbach: 0,80; coeficiente de correlação intraclasse: 0,97). Quanto à validade de construto convergente e divergente, foi verificada forte correlação entre a adesão às precauções-padrão e a percepção de clima de segurança e a menor percepção de obstáculos para segui-las (r = 0,614 e r = -0,537, respectivamente). Enfermeiros que receberam treinamento sobre as precauções-padrão e atuantes nos estabelecimentos de maior complexidade mostraram-se mais aderentes (p = 0,028 e p = 0,006, respectivamente). CONCLUSÕES : A versão brasileira do questionário de adesão às precauções-padrão mostrou-se válida e confiável. Futuras investigações devem ser realizadas com amostras de enfermeiros mais representativas da realidade brasileira. A utilização do questionário pode auxiliar na proposição de medidas educativas frente às possíveis lacunas identificáveis, com enfoque na saúde do trabalhador e na segurança do paciente.

Prevalence and opinions related to tobacco consuption by university students / Prevalência e crenças com relação ao consumo de cigarro pela população universitária / Prevalencia y creencias en relación al consumo de tabaco en población universitaria

Tobacco use represents one of the major public health problems; the aim of the study was to determine the prevalence and opinions of tobacco consumption by university population; a descriptive cross-sectional design was used. The results showed a prevalence of use in the last year of 24.3 of participants, consumption once in a lifetime was 46.3%. Regarding dissenting opinions (cons) about tobacco use it is found that a high percentage of participants presents obstacles to the use of tobacco; items that reached the highest levels were in relation to opinions on health, such as tobacco causing cancer and directly affecting the lungs and heart.(AU)

O consumo de cigarro representa um dos principais problemas de saúde pública. O objetivo do estudo foi determinar a prevalência e as crenças sobre o consumo do cigarro pela população universitária. Para tanto, empregou-se um desenho descritivo transversal. Os resultados mostraram uma prevalência de consumo no último ano de 24.3% dos participantes (alguma vez na vida o consumo foi de 46.3%). Com relação às crenças desfavoráveis (contras) ao consumo de cigarro, observa-se que uma alta porcentagem dos participantes apresentou barreiras ao consumo de cigarro. Os itens que alcançaram os índices mais altos foram aqueles relacionados com as crenças na área da saúde, como o entendimento de que o cigarro provoca câncer e afeta diretamente os pulmões e o coração.(AU)

El consumo de tabaco representa uno de los principales problemas de salud pública, el objetivo del estudio fue determinar la prevalencia y las creencias sobre el consumo del tabaco en la población universitaria, para ello se empleó un diseño descriptivo transversal. Los resultados mostraron una prevalencia de consumo en el ultimo año de 24.3% de los participantes (el consumo alguna vez en la vida fue de 46.3%). En relación a las creencias desfavorables (contras) para el consumo de tabaco, se observa que un alto porcentaje de los participantes presentó barreras para el consumo de tabaco, los ítems que más altos índices alcanzaron fueron respecto a la creencias de la salud como que el tabaco provoca cáncer y afecta directamente a los pulmones y al corazón.(AU)

Prevalence and opinions related to tobacco consuption by university students / Prevalência e crenças com relação ao consumo de cigarro pela população universitária / Prevalencia y creencias en relación al consumo de tabaco en población universitaria

Tobacco use represents one of the major public health problems; the aim of the study was to determine the prevalence and opinions of tobacco consumption by university population; a descriptive cross-sectional design was used. The results showed a prevalence of use in the last year of 24.3 of participants, consumption once in a lifetime was 46.3%. Regarding dissenting opinions (cons) about tobacco use it is found that a high percentage of participants presents obstacles to the use of tobacco; items that reached the highest levels were in relation to opinions on health, such as tobacco causing cancer and directly affecting the lungs and heart...

O consumo de cigarro representa um dos principais problemas de saúde pública. O objetivo do estudo foi determinar a prevalência e as crenças sobre o consumo do cigarro pela população universitária. Para tanto, empregou-se um desenho descritivo transversal. Os resultados mostraram uma prevalência de consumo no último ano de 24.3% dos participantes (alguma vez na vida o consumo foi de 46.3%). Com relação às crenças desfavoráveis (contras) ao consumo de cigarro, observa-se que uma alta porcentagem dos participantes apresentou barreiras ao consumo de cigarro. Os itens que alcançaram os índices mais altos foram aqueles relacionados com as crenças na área da saúde, como o entendimento de que o cigarro provoca câncer e afeta diretamente os pulmões e o coração...

El consumo de tabaco representa uno de los principales problemas de salud pública, el objetivo del estudio fue determinar la prevalencia y las creencias sobre el consumo del tabaco en la población universitaria, para ello se empleó un diseño descriptivo transversal. Los resultados mostraron una prevalencia de consumo en el ultimo año de 24.3% de los participantes (el consumo alguna vez en la vida fue de 46.3%). En relación a las creencias desfavorables (contras) para el consumo de tabaco, se observa que un alto porcentaje de los participantes presentó barreras para el consumo de tabaco, los ítems que más altos índices alcanzaron fueron respecto a la creencias de la salud como que el tabaco provoca cáncer y afecta directamente a los pulmones y al corazón...

Validation of an instrument to assess factors associated with adherence to standard precautions among dentists in primary healthcare.

Accidents with biological material are a reality in dental practice. The use of preventive measures such as the adoption of Standard Precautions (SP) is essential, thus this study aims to validate an instrument to check factors associated with adherence to SP among dentists. The scales of psychosocial and organizational factors that influence adherence to SP were the starting point. These scales have already been nationally validated for doctors and nurses. The instrument consisted of 49 items divided into five dimensions. The process of instrument validation involved the following steps: its adaptation for situations that pose risks to dentists; content and semantic analysis by a committee of judges, and application to dentists. The adapted instrument was applied to 224 dentists who provided primary healthcare in the north region of Paraná State. After the application of scales, the psychometric properties were analyzed using the factor analysis technique and a reliability test. The factor analysis confirmed three domains: Obstacles to following standard precautions; Knowledge of occupational transmission of HIV and Safety climate. The reliability of the domains was considered adequate (Cronbach's alpha between 0.73 and 0.88.). The instrument demonstrated adequate psychometric properties to assess factors that influence adherence to SP among dentists.

Transtornos mentais comuns e consumo de bebida alcoólica e tabaco entre estudantes de enfermagem de uma universidade pública na Amazônia Ocidental brasileira / Common mental disorders, alcohol consumption and tobacco use, among nursing students at a public university in the western Brazilian Amazon / Trastornos mentales comunes y consumo de bebida alcohólica y tabaco entre estudiantes de enfermería de una universidad pública en la Amazonía Occidental brasileña

O objetivo deste estudo é identificar a prevalência de transtornos mentais comuns e consumo de bebida alcoólica e tabaco entre estudantes de enfermagem de uma universidade pública da Amazônia Ocidental brasileira. Trata-se de um estudo exploratório e descritivo, utilizando-se os instrumentos AUDIT, SRQ-20 e questionário de tabagismo. Do total de estudantes, 93,4% afirmou fazer consumo de álcool de baixo risco, porém 26% afirmou beber no padrão binge pelo menos uma vez ao mês. Em relação ao tabaco, 78,6% afirmou ter usado por curiosidade e desejo de experimentar e 46,1% afirmou que "sente-se nervoso, tenso ou preocupado" e que tem "humor depressivo/ansioso". A comparação dos resultados possibilita o planejamento de programas de prevenção mais condizentes com as características e necessidade de cada comunidade.(AU)

The objective of this study is to identify the prevalence of two common mental disorders, alcohol consumption and tobacco use, among nursing students of a public university in the western Brazilian Amazon. This is an exploratory and descriptive study, using AUDIT instruments, SRQ-20 and smoking questionnaire. Of the total number of students 93.4% said they consume a low-risk amount of alcohol, but 26% said they binge drank at least once a month. As for tobacco, 78.6% claimed to have used it because of curiosity and the desire to experiment and 46.1% said they "felt nervous, tense or worried" and had a "depressive/anxious mood." In comparing these results it allows for a more consistent planning of prevention programs that addresses the needs of this community.(AU)

El objetivo de este estudio es identificar la prevalencia de trastornos mentales comunes y consumo de bebida alcohólica y tabaco entre estudiantes de enfermería de una universidad pública de la Amazonía Occidental brasileña. Se Trata de un estudio exploratorio y descriptivo, utilizándose los instrumentos AUDIT, SRQ-20 y el cuestionario de tabaquismo. Del total de estudiantes, 93,4% afirmó hacer consumo de alcohol de bajo riesgo, pero el 26% afirmó beber en el modelo binge por lo menos una vez al mes. En relación al tabaco, 78,6% afirmó haber usado por curiosidad y deseo de experimentar el 46,1% afirmó que "se siente nervioso, tenso o preocupado" y que tiene "humor depresivo/ansioso". La comparación de los resultados posibilita el planeamiento de programas de prevención más coincidentes con las características y necesidades de cada comunidad.(AU)

Transtornos mentais comuns e consumo de bebida alcoólica e tabaco entre estudantes de enfermagem de uma universidade pública na Amazônia ocidental brasileira / Common mental disorders, alcohol consumption and tobacco use, among nursing students at a public university in the western brazilian Amazon / Trastornos mentales comunes y consumo de bebida alcohólica y tabaco entre estudiantes de enfermería de una universidad pública en la Amazonía occidental brasileña

O objetivo deste estudo é identificar a prevalência de transtornos mentais comuns e consumo de bebida alcoólica e tabaco entre estudantes de enfermagem de uma universidade pública da Amazônia Ocidental brasileira. Trata-se de um estudo exploratório e descritivo, utilizando-se os instrumentos AUDIT, SRQ-20 e questionário de tabagismo. Do total de estudantes, 93,4% afirmou fazer consumo de álcool de baixo risco, porém 26% afirmou beber no padrão binge pelo menos uma vez ao mês. Em relação ao tabaco, 78,6% afirmou ter usado por curiosidade e desejo de experimentar e 46,1% afirmou que "sente-se nervoso, tenso ou preocupado" e que tem "humor depressivo/ansioso". A comparação dos resultados possibilita o planejamento de programas de prevenção mais condizentes com as características e necessidade de cada comunidade.

The objective of this study is to identify the prevalence of two common mental disorders, alcohol consumption and tobacco use, among nursing students of a public university in the western Brazilian Amazon. This is an exploratory and descriptive study, using AUDIT instruments, SRQ-20 and smoking questionnaire. Of the total number of students 93.4% said they consume a low-risk amount of alcohol, but 26% said they binge drank at least once a month. As for tobacco, 78.6% claimed to have used it because of curiosity and the desire to experiment and 46.1% said they "felt nervous, tense or worried" and had a "depressive/anxious mood." In comparing these results it allows for a more consistent planning of prevention programs that addresses the needs of this community.

El objetivo de este estudio es identificar la prevalencia de trastornos mentales comunes y consumo de bebida alcohólica y tabaco entre estudiantes de enfermería de una universidad pública de la Amazonía Occidental brasileña. Se Trata de un estudio exploratorio y descriptivo, utilizándose los instrumentos AUDIT, SRQ-20 y el cuestionario de tabaquismo. Del total de estudiantes, 93,4% afirmó hacer consumo de alcohol de bajo riesgo, pero el 26% afirmó beber en el modelo binge por lo menos una vez al mes. En relación al tabaco, 78,6% afirmó haber usado por curiosidad y deseo de experimentar el 46,1% afirmó que "se siente nervioso, tenso o preocupado" y que tiene "humor depresivo/ansioso". La comparación de los resultados posibilita el planeamiento de programas de prevención más coincidentes con las características y necesidades de cada comunidad.

Validation of an instrument to assess factors associated with adherence to standard precautions among dentists in primary healthcare

Accidents with biological material are a reality in dental practice.The use of preventive measures such as the adoption ofStandard Precautions (SP) is essential, thus this study aims tovalidate an instrument to check factors associated with adherenceto SP among dentists. The scales of psychosocial andorganizational factors that influence adherence to SP were thestarting point. These scales have already been nationally validatedfor doctors and nurses. The instrument consisted of 49items divided into five dimensions. The process of instrumentvalidation involved the following steps: its adaptation for situationsthat pose risks to dentists; content and semantic analysisby a committee of judges, and application to dentists. Theadapted instrument was applied to 224 dentists who providedprimary healthcare in the north region of Paraná State. Afterthe application of scales, the psychometric properties wereanalyzed using the factor analysis technique and a reliabilitytest. The factor analysis confirmed three domains: Obstaclesto following standard precautions; Knowledge of occupationaltransmission of HIV and Safety climate. The reliability of thedomains was considered adequate (Cronbach’s alpha between0.73 and 0.88.). The instrument demonstrated adequate psychometricproperties to assess factors that influence adherenceto SP among dentists...

Os acidentes com presença de material biológico são umarealidade na prática odontológica. A utilização de medidaspreventivas como a adoção das Precauções Padrão (PP) éessencial, desta maneira este estudo tem como objetivo validarum instrumento para verificação de fatores associadosà adesão às PP, entre dentistas. Partiram-se das Escalas deFatores Psicossociais e Organizacionais que Influenciam aAdesão às Precauções-Padrão, já validadas nacionalmentepara enfermeiros e médicos. O instrumento compôs-se de49 itens distribuídos em 5 dimensões. O processo de validaçãodo instrumento seguiu as seguintes etapas: adaptaçãodo instrumento para as situações que envolvem riscos aosdentistas por meio da análise semântica e análise de conteúdo,as quais foram realizadas por um comitê de juízes. Oinstrumento adaptado foi para 224 dentistas que atuavamna Rede Básica de Saúde na região Norte do Estado doParaná. Após aplicação das escalas foram analisadas aspropriedades psicométricas através das técnicas de análisefatorial e teste de confiabilidade. A análise fatorial confirmoutrês domínios: Obstáculo para seguir às PrecauçõesPadrão; Conhecimento da transmissão ocupacional do HIVe Clima de segurança. A confiabilidade dos domínios foiconsiderada adequada (alfa de Cronbach entre 0,73 e 0,88).O instrumento demonstrou propriedades psicométricas adequadaspara avaliar fatores de influência na adesão as PP,entre dentistas...

Ocorrência de acidentes de trabalho com material biológico potencialmente contaminado em enfermeiros / Occurrence of occupational accidents involving potentially contaminated biological material among nurses

Objetivo Investigar ocorrência e características dos acidentes com material biológico potencialmente contaminado em enfermeiros.Métodos Estudo transversal que incluiu 121 enfermeiros. O instrumento de pesquisa foi um questionário autoaplicável com variáveis sociodemográficas e relacionadas a acidentes de trabalho.Resultados Em relação à ocorrência de acidente do trabalho com exposição a material biológico potencialmente contaminado entre enfermeiros, 65 (53,8%) foram vítimas. Destes, 63(52,1%) por perfurocortantes e 22 (18,2%) por exposição à mucosa e/ou pele não íntegra. Não houve diferença estatisticamente significativa entre os grupos quanto à ocorrência e notificação do acidente (p=0,791 e p=0,427); conhecimento da resposta vacinal (p=0,379); troca de recipiente de perfurocortantes (p=0,372) e treinamento sobre precauções padrão (p=0,158). Com relação ao treinamento foi verificada diferença estatisticamente significativa (p=0,014) uma vez que enfermeiros nos estabelecimentos menores relataram maior desejo de participação.Conclusão Os acidentes são frequentes entre os enfermeiros e o treinamento relaciona-se positivamente à adesão às precauções-padrão.

Objective To investigate the occurrence and characteristics of accidents involving potentially contaminated biological material in nurses.Methods Cross-sectional study involving 121 nurses. The research instrument was a self-applied questionnaire with sociodemographic and occupational accident-related variables.Results Sixty-five (53.8) nurses were victims of occupational accidents involving exposure to potentially contaminated biological material. Sixty-three (52.1%) were related to piercing-cutting materials and 22 (18.2%) to exposure of the mucosa and/or non-intact skin. No statistically significant difference between the groups was found in terms of accident events and reporting (p=0.791 and p=0.427); knowledge of the immune response (p=0.379); change of piercing-cutting material collector (p=0.372) and training on standard precautions (p=0.158). A statistically significant different in the training was found (p=0.014), as nurses working at smaller establishments indicated greater desire to participate.Conclusion Accidents are frequent among the nurses and training is positively related with adherence to standard precautions.

Validation of an instrument to assess factors associated with adherence to standard precautions among dentists in primary healthcare. / Validation of an instrument to assess factors associated with adherence to standard precautions among dentists in primary healthcare.

Accidents with biological material are a reality in dental practice. The use of preventive measures such as the adoption of Standard Precautions (SP) is essential, thus this study aims to validate an instrument to check factors associated with adherence to SP among dentists. The scales of psychosocial and organizational factors that influence adherence to SP were the starting point. These scales have already been nationally validated for doctors and nurses. The instrument consisted of 49 items divided into five dimensions. The process of instrument validation involved the following steps: its adaptation for situations that pose risks to dentists; content and semantic analysis by a committee of judges, and application to dentists. The adapted instrument was applied to 224 dentists who provided primary healthcare in the north region of Paraná State. After the application of scales, the psychometric properties were analyzed using the factor analysis technique and a reliability test. The factor analysis confirmed three domains: Obstacles to following standard precautions; Knowledge of occupational transmission of HIV and Safety climate. The reliability of the domains was considered adequate (Cronbachs alpha between 0.73 and 0.88.). The instrument demonstrated adequate psychometric properties to assess factors that influence adherence to SP among dentists.

Under-reporting of accidents involving biological material by nursing professionals at a Brazilian emergency hospital.

BACKGROUND: Pathogens can be transmitted to health professionals after contact with biological material. The exact number of infections deriving from these events is still unknown, due to the lack of systematic surveillance data and under-reporting. METHODS: A cross-sectional study was carried out, involving 451 nursing professionals from a Brazilian tertiary emergency hospital between April and July 2009. Through an active search, cases of under-reporting of occupational accidents with biological material by the nursing team were identified by means of individual interviews. The Institutional Review Board approved the research project. RESULTS: Over half of the professionals (237) had been victims of one or more accidents (425 in total) involving biological material, and 23.76% of the accidents had not been officially reported using an occupational accident report. Among the underreported accidents, 53.47% were percutaneous and 67.33% were bloodborne. The main reason for nonreporting was that the accident had been considered low risk. CONCLUSIONS: The under-reporting rate (23.76%) was low in comparison with other studies, but most cases of exposure were high risk.

Metoprolol oxidation polymorphism in Brazilian elderly cardiac patients.

OBJECTIVES: The purpose of this study was to phenotype the CYP2D6 in elderly with heart disease classified as extensive metabolizer or poor metabolizers (PM) of metoprolol, develop and validate the method of analysis of metoprolol tartrate and its metabolite in urine using HPLC, and identify potential correlations between anthropometric factors with metabolic ratios of metoprolol/α-OH metoprolol in urine. METHODS: The sample was composed of 130 elderly individuals with a previously identified type of heart condition, with normal renal and hepatic functions. The urine of all the patients were collected 0-8 h after the administration of a pill of 100 mg of metoprolol to determine concentrations of metoprolol and α-hydroxymetoprolol. Those patients presenting a metabolic ratio greater than 12.6 were phenotyped as PM. KEY FINDINGS: The median age of patients was 71.0 years, with a minimum of 60 and maximum of 93 years old. Three patients (2.3%) were phenotyped as PM of metoprolol different from the rate (7-10%) of PM existing in the Caucasian population. CONCLUSIONS: Most of the studied individuals were women, and the proportion of elderly with heart disease classified as PM was smaller than what is usually found among Caucasian populations.

[Care and specialized clinical follow-up of nursing professionals who have been victims of accidents with biological material]. / Atendimento e seguimento clínico especializado de profissionais de enfermagem acidentados com material biológico.

This cross-sectional study aimed to evaluate the conduct of nursing professionals who had been victims of accidents with biological material in a teaching hospital in the interior of the state of São Paulo, Brazil, regarding their care and specialized clinical follow-up. The study population consisted of 1,215 nursing professionals, who were interviewed individually between 2010 and 2011. Of the 1,215 nursing professionals interviewed, 636 (52.3%) reported having experienced accidents with biological material; of this population, 182 (28.6%) didn't sought specialized care. The most frequent reason reported for not seeking care was believing that it was a low-risk accident. The reasons professionals do not seek care and do not complete treatment and the clinical follow-up can contribute to strategies to increase professionals' adherence to prophylaxis measures after occupational exposure to biological material.

Atendimento e seguimento clínico especializado de profissionais de enfermagem acidentados com material biológico / Care and specialized clinical follow-up of nursing professionals who have been victims of accidents with biological material / Atención y seguimiento clínico especializado de profesionales de enfermería accidentados con material biológico

O presente trabalho trata-se de estudo de corte transversal, com objetivo de avaliar a conduta dos profissionais de enfermagem vítimas de acidentes com material biológico, do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, no estado de São Paulo, referente ao atendimento e ao seguimento clínico especializado. A população foi composta por 1.215 profissionais de enfermagem, entrevistados entre os anos de 2010 e 2011, dos quais 636 (52,3%) sofreram acidentes com material biológico e 182 (28,6%) não procuraram atendimento no serviço especializado. O motivo mais frequentemente relatado foi atribuir pouco risco ao acidente. Assim, acredita-se que os motivos alegados pelos profissionais para não procurarem o atendimento, para não completarem a terapêutica e nem o seguimento clínico podem contribuir para a proposição de estratégias capazes de aumentar a adesão às medidas profiláticas após exposição ocupacional a material biológico.

This cross-sectional study aimed to evaluate the conduct of nursing professionals who had been victims of accidents with biological material in a teaching hospital in the interior of the state of São Paulo, Brazil, regarding their care and specialized clinical follow-up. The study population consisted of 1,215 nursing professionals, who were interviewed individually between 2010 and 2011. Of the 1,215 nursing professionals interviewed, 636 (52.3%) reported having experienced accidents with biological material; of this population, 182 (28.6%) didn't sought specialized care. The most frequent reason reported for not seeking care was believing that it was a low-risk accident. The reasons professionals do not seek care and do not complete treatment and the clinical follow-up can contribute to strategies to increase professionals' adherence to prophylaxis measures after occupational exposure to biological material.

Estudio de corte transversal, apuntando a evaluar la conducta de profesionales de enfermería víctimas de accidentes con material biológico, del Hospital de Clínicas de la Facultad de Medicina de Ribeirão Preto, Universidad de São Paulo, en el estado de São Paulo; referente a la atención y seguimiento clínico especializado. La población estuvo integrada por 1215 profesionales de enfermería, entrevistados entre 2010 y 2011, de los cuales 636 (52,3%) sufrieron accidentes con material biológico y 182 (28,6%) no solicitaron atención en el servicio especializado. El motivo relatado con mayor frecuencia fue atribuir escaso riesgo al accidente. De tal modo, se cree que los motivos alegados por los profesionales para no solicitar atención, para no completar la terapéutica ni el seguimiento clínico pueden ser facilitar la propuesta de estrategias capaces de aumentar su adhesión a las medidas profilácticas luego de exposición laboral a materiales biológicos.

Cultural adaptation and psychometric properties of the family questionnaire in a Brazilian sample of relatives of schizophrenia outpatients.

AIMS AND OBJECTIVES: To evaluate the internal reliability and validity of the Brazilian Portuguese version of the Family Questionnaire among families of schizophrenia outpatients. BACKGROUND: The main studies about the family environment of schizophrenia patients are related to the concept of Expressed Emotion. There is currently no instrument to evaluate this concept in Brazil that is easily applicable and comparable with studies from other countries. DESIGN: Methodological and cross-sectional research design. METHOD: A convenience sample of 130 relatives of schizophrenia outpatients was selected. The translation and cultural adaptation of the instrument involved experts in mental health and experts in the German language and included back translation, semantic evaluation of items and pretesting of the instrument with 30 relatives of schizophrenia outpatients. The psychometric properties of the instrument were studied with another 100 relatives, which fulfilled the requirements for the Brazilian Portuguese version of the instrument. The psychometric properties of the instrument were assessed by construct validity (using an analysis of its key components, comparisons between distinct groups-convergent validity with the Antonovsky's Sense of Coherence Scale) and reliability (checking the internal consistency of its items and its test-retest reproducibility). RESULTS: The analysis of main components confirmed dimensionality patterns that were comparable between the original and adapted versions. In two domains of the instrument, critical comments and emotional over-involvement had moderate and significant correlations, respectively, with Antonovsky's Sense of Coherence Scale, appropriate values of Cronbach's alpha and strong and significant correlations, respectively, in test-retest reproducibility. We observed significant differences between distinct groups of parents in the category of emotional over-involvement. CONCLUSION: We conclude that the Portuguese-adapted version of the Family Questionnaire is valid and reliable for the study sample. RELEVANCE TO CLINICAL PRACTICE: This study provided evidence that the Family Questionnaire is a reliable and valid instrument for assessing expressed emotion. It is easy and practical to use and is acceptable for use in a Brazilian cultural population.

Comunicação participativa: perfil clínico de pacientes diabéticos antes e após intervenção educativa / Participatory communication: clinical profile of diabetic patients before and after educational intervention / Comunicación participativa: perfil clínico de pacientes diabéticos antes y después de intervención educativa

Este estudo quase-experimental teve como objetivo avaliar o estado físico geral de pacientes diabéticos mexicanos antes e após a implementação de um programa de ensino baseado na comunicação participativa e tradicional. O grupo experimental participou do programa de ensino para cuidados com os pés utilizando a comunicação participativa e o grupo controle utilizou o método de comunicação tradicional. Os dados foram obtidos em 2007, através de exame físico e entrevista em três momentos: antes do início, no final do programa e seis meses após o término da intervenção. A maior parte dos participantes era do sexo feminino, com média de idade 52 anos. As variáveis exames laboratoriais e exame físico apresentaram perfis distintos (p<0,001), constatando-se que o programa baseado na comunicação participativa foi melhor do que o da metodologia tradicional. Estratégias de ensino como da comunicação participativa podem resultar em maior eficácia no alcance dos objetivos da educação em saúde.

This quasi-experimental study aimed to assess the general physical condition of Mexican diabetic patients before and after implementation of a teaching program based on participatory and traditional communication. The experimental group participated in the teaching program for foot care using participatory communication and the control group used the traditional communication method. Data were obtained in 2007 through clinical examination and interview at threemoments: before the beginning, at the end of the program, and six months after the end of intervention. Most participants were female, with average age of 52 years. Laboratory tests and physical examination variables showed different profiles (p<0.001). The program based on participatory communication proved to be better than the traditional method. Teaching strategies such as participatory communication can result in higher goal achievement efficiency levels in health education.

Este estudio cuasi-experimental evaluó la condición física general de los pacientes diabéticos mejicanos antesy después de la implementación de un programa de enseñanza basado en la comunicación participativa y tradicional. El grupo experimental participó en el programa de enseñanza para el cuidado de los pies utilizando comunicación participativa, mientras el grupo control utilizó el método tradicional de comunicación. Los datos fueron obtenidos en 2007, a través del examen físico y de entrevista en tres momentos: antes del inicio, al final del programa y seis meses después del término de la intervención. La mayoría de los participantes eran mujeres, con edad media de 52 años. Las variables testes de laboratorio y examen físico presentaron perfiles distintos (p<0,001), señalando que el programa de educación basado en la comunicación participativa fue mejor que el método tradicional. Estrategias de enseñanza tales como la comunicación participativa pueden resultar en una mayor eficacia en el alcance de los objetivos de educación en salud.