Working conditions and mental health of community health workers in the COVID-19 pandemic. / Condições de trabalho e saúde mental de agentes comunitários de saúde na pandemia de COVID-19.

This study examined the prevalence of anxiety and depression associated with Community Health Workers' (CHWs') working conditions in the context of the COVID-19 pandemic. This cross-sectional study was carried out in the north of Minas Gerais, Brazil by applying a questionnaire addressing sociodemographic conditions, command of technologies and working conditions during the pandemic, as well as the State-Trait Anxiety Inventory and the Patient Health Questionnare-9 (PHQ-9). Descriptive and multiple Poisson regression analyses were performed with robust variance, to a 5% level of significance (p < 0.05) for the final model. A total of 1,220 CHWs from 36 municipalities participated in the study. Prevalences were 41.8% and 31.6% for anxiety and depression, respectively, while 22.5% of the group displayed symptoms of both conditions. Being female, up to 40 years old, having more than 500 users registered for monitoring, and inadequate supply of personal protective equipment were associated with anxiety and depression among the CHWs. Prevalence of anxiety and depression was high among CHWs during the pandemic and working conditions figured prominently among the associated factors.

O objetivo deste estudo foi analisar a prevalência de ansiedade e depressão associada às condições de trabalho dos agentes comunitários de saúde (ACS) no contexto da pandemia de COVID-19. Estudo transversal, realizado no norte de Minas Gerais. Foi aplicado um questionário que abordava condições sociodemográficas, domínio de tecnologias e condições de trabalho durante a pandemia, além do Inventário de Ansiedade Traço-Estado e do Patient Health Questionnare-9 (PHQ-9). Foram realizadas análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p < 0,05) para o modelo final. Participaram do estudo 1.220 ACS de 36 municípios. A prevalência foi de 41,8% e 31,6% para ansiedade e depressão, respectivamente, e 22,5% para ambas as condições. O sexo feminino, idade até 40 anos, ter mais de 500 usuários cadastrados para acompanhamento e oferta inadequada de equipamentos de proteção individual estiveram associados à ansiedade e à depressão. Registrouse uma elevada prevalência de ansiedade e depressão entre ACS no período da pandemia, com destaque para as condições de trabalho entre os fatores associados.

Physical Activity among Elderly Teachers Working in Basic Education Schools.

This study aimed to assess the levels of physical activity (PA) among elderly teachers. It was an epidemiological, cross-sectional, and analytical web survey conducted with teachers working in public basic education schools. Data collection took place between October and December 2021 through an online form. The dependent variable was physical activity practice, classifying teachers as either physically active or inactive. Descriptive, bivariate, and multiple analyses were performed using Poisson Regression with robust variance. A total of 1907 teachers participated in the study, of whom 5.6% were elderly, ranging in age from 60 to 72 years. Regarding PA practice, elderly teachers were found to be more physically inactive compared with adult teachers (PR = 1.18; 95% CI = 1.04; 1.34). Conclusion: A statistically significant difference in PA practice was observed between adult and elderly teachers, indicating that elderly teachers are more physically inactive.

Condições de trabalho e saúde mental de agentes comunitários de saúde na pandemia de COVID-19 / Working conditions and mental health of community health workers in the COVID-19 pandemic

Resumo O objetivo deste estudo foi analisar a prevalência de ansiedade e depressão associada às condições de trabalho dos agentes comunitários de saúde (ACS) no contexto da pandemia de COVID-19. Estudo transversal, realizado no norte de Minas Gerais. Foi aplicado um questionário que abordava condições sociodemográficas, domínio de tecnologias e condições de trabalho durante a pandemia, além do Inventário de Ansiedade Traço-Estado e do Patient Health Questionnare-9 (PHQ-9). Foram realizadas análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p < 0,05) para o modelo final. Participaram do estudo 1.220 ACS de 36 municípios. A prevalência foi de 41,8% e 31,6% para ansiedade e depressão, respectivamente, e 22,5% para ambas as condições. O sexo feminino, idade até 40 anos, ter mais de 500 usuários cadastrados para acompanhamento e oferta inadequada de equipamentos de proteção individual estiveram associados à ansiedade e à depressão. Registrouse uma elevada prevalência de ansiedade e depressão entre ACS no período da pandemia, com destaque para as condições de trabalho entre os fatores associados.

Abstract This study examined the prevalence of anxiety and depression associated with Community Health Workers' (CHWs') working conditions in the context of the COVID-19 pandemic. This cross-sectional study was carried out in the north of Minas Gerais, Brazil by applying a questionnaire addressing sociodemographic conditions, command of technologies and working conditions during the pandemic, as well as the State-Trait Anxiety Inventory and the Patient Health Questionnare-9 (PHQ-9). Descriptive and multiple Poisson regression analyses were performed with robust variance, to a 5% level of significance (p < 0.05) for the final model. A total of 1,220 CHWs from 36 municipalities participated in the study. Prevalences were 41.8% and 31.6% for anxiety and depression, respectively, while 22.5% of the group displayed symptoms of both conditions. Being female, up to 40 years old, having more than 500 users registered for monitoring, and inadequate supply of personal protective equipment were associated with anxiety and depression among the CHWs. Prevalence of anxiety and depression was high among CHWs during the pandemic and working conditions figured prominently among the associated factors.

Análise dos indicadores de prazer e sofrimento no trabalho associados a ansiedade e depressão entre agentes comunitários de saúde / Analysis of indicators of pleasure and suffering at work associated with anxiety and depression among community health agents

RESUMO Objetivo Analisar os indicadores de prazer e sofrimento no trabalho associados a depressão e ansiedade entre agentes comunitários de saúde (ACSs). Métodos Estudo transversal, no qual variáveis dependentes foram a presença de sintomas de ansiedade e depressão, avaliadas com o Patient Health Questionnaire (PHQ-9) e com o Inventário de Ansiedade de Traço-Estado (IDATE). As variáveis independentes foram avaliadas com um questionário sociodemográfico e a Escala de Indicadores de Prazer e Sofrimento no Trabalho (EIPST) do Inventário do Trabalho e Riscos de Adoecimento (ITRA). As associações entre as variáveis foram testadas com o uso de regressão logística multinominal. Resultados Participaram do estudo 675 ACSs, sendo a maioria mulheres (83,7%), com até 40 anos (51,3%). As chances de apresentar sintomas de ansiedade foram maiores entre ACSs efetivos (1,61 [1,10-2,36]), e avaliações críticas ou graves nos fatores realização (Crítica 1,87 [1,30-2,68]; Grave 4,16 [2,06-8,40]) e esgotamento profissional (Crítica 2,60 [1,78-3,80]; Grave 3,97 [2,53-6,21]). Sexo feminino (2,12 [1,03-4,40]), idade de até 40 anos (1,741 [1,05-2,89]), tempo de serviço superior a cinco anos (1,88 [1,18-2,99]), avaliações crítica ou grave nos fatores realização (Crítica 2,53 [1,55-4,10]; Grave 6,07 [2,76-13,38]), esgotamento profissional (Crítica 5,21 [2,30-11,80]; Grave 15,64 [6,53-37,44]) e falta de reconhecimento (Crítica 1,93 [1,13-3,28]) estiveram associados a maiores chances de sintomas depressivos. Conclusões Apesar de se tratar de estudo transversal, que não permite inferir causalidade, os achados sugerem importante associação entre aspectos laborais dos ACS e os sintomas de ansiedade e depressão. Sexo feminino e possuir 40 anos ou menos também mostraram relação com o aumento dos sintomas de depressão.

ABSTRACT Objective To analyze indicators of pleasure and suffering at work associated with depression and anxiety among community health workers (CHW). Methods Crosssectional study in which the dependent variables were the presence of anxiety and depression symptoms, assessed using the Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI). The independent variables were evaluated using the Scale of Indicators of Pleasure and Suffering at Work (EIPST) of the Inventory of Work and Risks of Illness (ITRA). Associations between dependent and independent variables were tested using multinomial logistic regression. Results 675 CHW participated in the study, the majority being women (83.7%), aged up to 40 years (51.3%). The chances of presenting anxiety symptoms were higher among effective CHW (OR=1.61; 95%CI: 1.10-2.36), and critical or severe assessments in the achievement factors (Critical OR=1.87; 95%CI: 1.30-2.68; Severe OR=4.16; 95%CI: 2.06-8.40) and professional exhaustion (Critical OR=2.60; 95%CI: 1.78-3.80; Severe OR=3.97; 95% CI: 2.53-6.21). Female gender (OR=2.12; 95%CI: 1.03-4.40), age up to 40 years (OR=1.74; 95%CI: 1.05-2.89), length of service greater than five years (OR=1.88; 95%CI: 1.18-2.99), critical or severe ratings on achievement factors (Critical OR=2.53; 95%CI: 1.55-4.10; Severe OR= 6.07; 95%CI: 2.76-13.38), professional exhaustion (Critical OR=5.21; 95%CI: 2.30-11.80; Severe OR=15.64; 95%CI: 6.53 -37.44) and lack of recognition (Critical OR=1.93; 95%CI: 1.13-3.28) were associated with greater chances of depressive symptoms. Conclusions Despite being a cross-sectional study, which does not allow inferring causality, the findings suggest an important association between the work aspects of the CHW and the symptoms of anxiety and depression. Female gender and being 40 years old or younger also showed a relationship with increased symptoms of depression.

Voice Disorders and Mental health of Basic Education Teachers in a Brazilian Municipality.

OBJECTIVE: To identify associations with voice disorders in elementary school teachers of a Brazilian municipality STUDY DESIGN: This was a quantitative cross-sectional and analytical study with probability sampling carried out in the 2016 school year METHOD: Self-report of vocal complaints was used for the dependent variable vocal disorder. The independent variables were sociodemographic and occupational characteristics, working conditions that generate discomfort, habits and behaviors, mental health and self-perception of health. For the evaluation of the Burnout Syndrome (BS), the questionnaire Cuestionário para la Evaluación del Syndrome de Quemarse por el Trabajo (CESQT) was used and, for depression, the Beck Depression Inventory (BDI) scale instrument. Multiple fit models were used applying the Binary Logistic Regression RESULTS: A total of 634 teachers participated in this study. There was a predominance of women (85.3%) with mean age 40.6 years (SD ±9.5); 62.1% were married, 70.2% had children and a mean teaching time of 12.9 years (SD ±8.4); 19.3% had voice disorders; 14.5% experienced BS and 24.0% depression. Voice disorders were associated with women (OR=2.30) working longer weekly hours (OR=1.75), with psycho-emotional problems, with burnout (OR=1.95) and depressive symptoms (OR=1.70), and were also associated with women who reported negative self-perception of health (OR= 1.97) CONCLUSION: Voice disorders appear to be strongly associated with mental health problems, mainly in women, in those with a longer working week and those who reported a negative perception of health. Public policies are required to prevent psycho-emotional problems and for vocal health promotion of the teaching category.

Prevalência de problemas vocais entre professores da educação básica e sua relação com o nível de atividade física / Prevalence of vocal problems among teachers of primary education and its relationship with the level of physical activity

Resumo Introdução A atividade física é benéfica para a manutenção da saúde, qualidade de vida, bem-estar físico e psicológico. No entanto, ainda são poucos os estudos que abordam a prática de atividade física e os problemas vocais. Objetivo Verificar a prevalência de problemas vocais e sua associação com o nível de atividade física em professores de escolas públicas da educação básica. Método Estudo transversal analítico com amostra probabilística por conglomerado em estágio único composta de 634 professores. A variável dependente referiu-se à existência de problemas vocais (quatro ou mais sinais/sintomas). As variáveis independentes foram relacionadas aos aspectos sociodemográficos, ocupacionais, hábitos de vida e saúde, consideradas na modelagem como fatores de ajuste. O nível de atividade física foi mensurado pelo International Physical Activity Questionnaire - IPAQ (versão curta). Procedeu-se à análise descritiva, bivariada e múltipla (Regressão de Poisson). Resultados Houve alta prevalência de sinais/sintomas vocais (79,2%), bem como daqueles com quatro ou mais sinais/sintomas, denominados de problemas vocais (27,3%). No modelo final ajustado, a prevalência de problemas vocais foi maior entre professores do sexo feminino (RP=1,9), com maior tempo de docência (RP=1,3), com qualidade de vida insatisfatória no domínio físico (RP=1,9) e no domínio psicológico (1,4) e entre os professores sedentários/insuficientemente ativos (RP=1,3). Conclusão A prática de atividade física mostrou relação com a saúde vocal mesmo após controle por outras variáveis, o que enfatiza a necessidade de conscientização e estímulo aos professores quanto à prática de atividade física.

Abstract Background Physical activity is beneficial for maintaining health, quality of life, physical and psychological well-being. However, there are still few studies that have the practice of physical activity and vocal problems. Objective To identify the prevalence of vocal problems and their association with the level of physical activity in public elementary school teachers. Method A cross-sectional analytical study with a probabilistic sample of a single-stage conglomerate composed of 634 teachers was carried out. The dependent variable was the existence of vocal issues (four or more signs/symptoms). The independent variables were related to sociodemographic, occupational, and life and health aspects, and they were considered in the modeling as adjustment factors. The level of physical activity was measured by the International Physical Activity Questionnaire - IPAQ (short version). Descriptive, bivariate, and multiple analyzes were performed (Poisson Regression). Results There was a high prevalence of vocal signs/symptoms (79.2%), as well as those with four or more signs/symptoms, called vocal problems (27.3%). In the adjusted final model, the prevalence of vocal problems was higher among female teachers (PR = 1.9), with a longer teaching period (PR = 1.3), with poor quality of life in the physical domain (PR = 1.9) and in the psychological domain (1.4), and among sedentary/insufficiently active teachers (PR = 1.3). Conclusion The practice of physical activity showed a relationship with vocal health even after controlling the other variables, which emphasizes the need for teacher awareness and encouragement regarding the practice of physical activity.

Clustering of behavioral risk factors for chronic noncommunicable diseases in climacteric women.

OBJECTIVE: To estimate the prevalence of clustering of behavioral risk factors for chronic non-communicable diseases, as well as the associated factors in climacteric women. METHODS: This is a cross-sectional, analytical study, with random selection of climacteric women, aged between 40 and 65 years, and registered in Family Health Strategy units. The dependent variable was clustering of three or more behavioral risk factors for chronic non-communicable diseases. The definition of associated variables was made after Poisson multiple regression analysis with robust variance. RESULTS: We evaluated 810 women, and 259 (32.0%) had a clustering of risk factors. The main risk behaviors were physical inactivity and low fruit consumption. The variables associated with clustering of behavioral factors were age group 52-65-years, marital status without a partner, overweight/obesity, moderate to severe anxiety and depression symptoms. CONCLUSION: There was a considerable prevalence of women with three or more behavioral risk factors for chronic non-communicable diseases. Demographic variables and those related to health conditions were shown to be associated. Considering the results recorded, health services must provide differentiated care policies to climacteric women, seeking to alleviate high morbidity and mortality of chronic non-communicable diseases.

Clustering of behavioral risk factors for chronic noncommunicable diseases in climacteric women

ABSTRACT Objective To estimate the prevalence of clustering of behavioral risk factors for chronic non-communicable diseases, as well as the associated factors in climacteric women. Methods This is a cross-sectional, analytical study, with random selection of climacteric women, aged between 40 and 65 years, and registered in Family Health Strategy units. The dependent variable was clustering of three or more behavioral risk factors for chronic non-communicable diseases. The definition of associated variables was made after Poisson multiple regression analysis with robust variance. Results We evaluated 810 women, and 259 (32.0%) had a clustering of risk factors. The main risk behaviors were physical inactivity and low fruit consumption. The variables associated with clustering of behavioral factors were age group 52-65-years, marital status without a partner, overweight/obesity, moderate to severe anxiety and depression symptoms. Conclusion There was a considerable prevalence of women with three or more behavioral risk factors for chronic non-communicable diseases. Demographic variables and those related to health conditions were shown to be associated. Considering the results recorded, health services must provide differentiated care policies to climacteric women, seeking to alleviate high morbidity and mortality of chronic non-communicable diseases.

Sociodemographic and occupational factors associated with anxiety symptoms in Community Health Agents. / Fatores sociodemográficos e ocupacionais associados aos sintomas de ansiedade entre Agentes Comunitários de Saúde.

Community Health Agents (CHAs) play a crucial role in assisting the population. Due to the complexity of functions and situations to which they are exposed, they can present with emotional problems. The aim of this article was to verify the prevalence of anxiety symptoms and the association with sociodemographic and occupational factors in community health agents. It is a cross-sectional and populational study that used a questionnaire to collect data on the sociodemographic, economic and occupational conditions and the State Trait Anxiety Inventory (STAI). Descriptive analyses and multiple Poisson regression were performed with robust variation, considering a 5% significance level (p <0.05) for the final model. A total of 673 community health agents were evaluated. The prevalence of anxiety symptoms in the STAI-State was 47.4% and in the STAI-trait, 42.4%. The time working as a CHA longer than five years was associated with the STAI-state (p<0.001) and the STAI-trait (p=0.018), where as the female gender was associated with the STAI-trait (p=0.011). A high prevalence of anxiety symptoms in community health agents was verified. Health promotion strategies aimed at improving and monitoring the mental health of these workers by reducing anxiety disorders is required.

Os Agentes Comunitários de Saúde possuem papel fundamental para o atendimento à população. Devido à complexidade de funções e situações que são expostos podem apresentar problemas emocionais. O objetivo deste artigo foi verificar a prevalência dos sintomas de ansiedade e a associação com os fatores sociodemográficos e ocupacionais entre agentes comunitários de saúde. Estudo transversal, populacional, no qual utilizou-se o Inventário de Ansiedade Traço Estado (IDATE- Traço e IDATE-Estado) e um questionário sobre as condições sociodemográficas e ocupacionais. Realizou-se análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p<0,05) para o modelo final. Foram avaliados 673 agentes comunitários de saúde, a prevalência dos sintomas de ansiedade no IDATE-estado foi de 47,4% e no IDATE-traço, 42,4%. O tempo de trabalho acima de cinco anos esteve associado ao IDATE-estado (p<0,001) e ao IDATE-traço (p=0,018), o sexo feminino ficou associado ao IDATE-traço (p=0,011). Verificou-se alta prevalência de sintomas de ansiedade entre os agentes comunitários da saúde. Há necessidade de estratégias que visem a promoção, proteção, monitoramento da saúde mental desses trabalhadores, reduzindo os transtornos de ansiedade.

Working conditions, lifestyle and mental health of Brazilian public-school teachers during the COVID-19 pandemic.

This study aimed to describe the working conditions, lifestyle and mental health of Brazilian public-school teachers during the COVID-19 pandemic. This is an epidemiological websurvey, carried out from August to September 2020. Teachers from public schools in rural and urban areas in the state of Minas Gerais, Brazil, participated in the study. A digital questionnaire was used and the study addressed variables related to four major thematic topics: sociodemographic and economic profile, working conditions, lifestyle and health conditions, and mental health problems during the pandemic. The sample consisted of 15,641 teachers, of which 13.3% worked in rural areas, 81.9% were women, 56.2% were aged 41-60 years, 66.8% were married, 99.2% were working remotely and 79.8% adhered to social distancing. During the pandemic, 40.6% showed a decrease in family income, 33.7% were dissatisfied with their work, 58% reported increased body weight, 47.9% did not exercise, 35.8% were part of at least one risk group for COVID-19, 40.5% had some flu-like symptoms during the pandemic and 1.2% tested positive for COVID-19. Regarding mental health problems, 25.9% of teachers self-reported formal diagnosis of anxiety and/or depression during the pandemic. In addition, 7.1% of teachers were drinking more alcohol than usual, 33.4% started having sleep problems, 30.4% were using relax/sleep/anxiety/depression medications, 67.1% reported that their quality of life worsened and 43.7% reported having severe fear of COVID-19. It was also found that 82.3% of teachers had at least one mental health problem during the pandemic, such as increased alcohol consumption, sleep problems, use of psychotropic medication, decreased quality of life, and fear of COVID-19. The results of this study reveal the numerous challenges and the extent of the impact of the pandemic on working conditions, lifestyle, and especially on the mental health of teachers.

Fatores sociodemográficos e ocupacionais associados aos sintomas de ansiedade entre Agentes Comunitários de Saúde / Sociodemographic and occupational factors associated with anxiety symptoms in Community Health Agents

Resumo Os Agentes Comunitários de Saúde possuem papel fundamental para o atendimento à população. Devido à complexidade de funções e situações que são expostos podem apresentar problemas emocionais. O objetivo deste artigo foi verificar a prevalência dos sintomas de ansiedade e a associação com os fatores sociodemográficos e ocupacionais entre agentes comunitários de saúde. Estudo transversal, populacional, no qual utilizou-se o Inventário de Ansiedade Traço Estado (IDATE- Traço e IDATE-Estado) e um questionário sobre as condições sociodemográficas e ocupacionais. Realizou-se análises descritivas e de regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p<0,05) para o modelo final. Foram avaliados 673 agentes comunitários de saúde, a prevalência dos sintomas de ansiedade no IDATE-estado foi de 47,4% e no IDATE-traço, 42,4%. O tempo de trabalho acima de cinco anos esteve associado ao IDATE-estado (p<0,001) e ao IDATE-traço (p=0,018), o sexo feminino ficou associado ao IDATE-traço (p=0,011). Verificou-se alta prevalência de sintomas de ansiedade entre os agentes comunitários da saúde. Há necessidade de estratégias que visem a promoção, proteção, monitoramento da saúde mental desses trabalhadores, reduzindo os transtornos de ansiedade.

Abstract Community Health Agents (CHAs) play a crucial role in assisting the population. Due to the complexity of functions and situations to which they are exposed, they can present with emotional problems. The aim of this article was to verify the prevalence of anxiety symptoms and the association with sociodemographic and occupational factors in community health agents. It is a cross-sectional and populational study that used a questionnaire to collect data on the sociodemographic, economic and occupational conditions and the State Trait Anxiety Inventory (STAI). Descriptive analyses and multiple Poisson regression were performed with robust variation, considering a 5% significance level (p <0.05) for the final model. A total of 673 community health agents were evaluated. The prevalence of anxiety symptoms in the STAI-State was 47.4% and in the STAI-trait, 42.4%. The time working as a CHA longer than five years was associated with the STAI-state (p<0.001) and the STAI-trait (p=0.018), where as the female gender was associated with the STAI-trait (p=0.011). A high prevalence of anxiety symptoms in community health agents was verified. Health promotion strategies aimed at improving and monitoring the mental health of these workers by reducing anxiety disorders is required.

Factors associated with voice complaints in community health agents. / Fatores associados às queixas vocais autorreferidas por agentes comunitários de saúde.

PURPOSE: To verify the prevalence of vocal complaints and their association with sociodemographic, economic, occupational, and behavioral factors among the population of Community Health Agents (CHA). METHODS: This is a cross-sectional and analytical study conducted in the city of Montes Claros, MG, in which 674 CHA participated. Data were collected via a self-administered questionnaire that includes sociodemographic, economic, behavioral, occupational, and voice-use aspects based on the Screening Index for Voice Disorder (SIVD). Bivariate analysis was performed by Pearson's chi-square test and Poisson multiple regression with robust variance to verify the association between the variables. RESULTS: There was a high prevalence of vocal complaints, the most cited being dry throat, throat clearing, tiredness when talking, and hoarseness. We observed a significant association between female gender, lack of restful sleep, alcohol use, regular to very poor self-rated health, and anxiety. CONCLUSION: There was a significant percentage of vocal complaints, and the associated factors found will guide actions to promote vocal and general health.

OBJETIVO: Verificar a prevalência das queixas vocais e a associação com os fatores sociodemográficos, econômicos, ocupacionais e comportamentais entre a população de Agentes Comunitários de Saúde (ACS). MÉTODO: Trata-se de um estudo transversal e analítico, realizado no município de Montes Claros, MG, no qual participaram 674 ACS. Para os aspectos sobre o uso da voz foi aplicado o Índice de Triagem de Distúrbio de Voz (ITDV) e os demais dados contemplavam as condições sociodemográficas, econômicas, ocupacionais e comportamentais. Realizou-se a análise bivariada, pelo teste do qui-quadrado de Pearson, e a regressão múltipla de Poisson com variância robusta para verificar a associação entre as variáveis. RESULTADOS: Houve alta prevalência de queixas vocais, sendo as mais citadas: garganta seca, pigarro, cansaço ao falar e rouquidão. Verificou-se associação significativa entre: sexo feminino, falta de sono reparador, uso de bebidas alcóolicas, autoavaliação da saúde regular a muito ruim e ansiedade. CONCLUSÃO: Houve uma porcentagem significativa de queixas vocais e os fatores associados encontrados nortearão ações de promoção da saúde vocal e geral.

Fatores associados às queixas vocais autorreferidas por agentes comunitários de saúde / Factors associated with voice complaints in community health agents

RESUMO Objetivo Verificar a prevalência das queixas vocais e a associação com os fatores sociodemográficos, econômicos, ocupacionais e comportamentais entre a população de Agentes Comunitários de Saúde (ACS). Método Trata-se de um estudo transversal e analítico, realizado no município de Montes Claros, MG, no qual participaram 674 ACS. Para os aspectos sobre o uso da voz foi aplicado o Índice de Triagem de Distúrbio de Voz (ITDV) e os demais dados contemplavam as condições sociodemográficas, econômicas, ocupacionais e comportamentais. Realizou-se a análise bivariada, pelo teste do qui-quadrado de Pearson, e a regressão múltipla de Poisson com variância robusta para verificar a associação entre as variáveis. Resultados Houve alta prevalência de queixas vocais, sendo as mais citadas: garganta seca, pigarro, cansaço ao falar e rouquidão. Verificou-se associação significativa entre: sexo feminino, falta de sono reparador, uso de bebidas alcóolicas, autoavaliação da saúde regular a muito ruim e ansiedade. Conclusão Houve uma porcentagem significativa de queixas vocais e os fatores associados encontrados nortearão ações de promoção da saúde vocal e geral.

ABSTRACT Purpose To verify the prevalence of vocal complaints and their association with sociodemographic, economic, occupational, and behavioral factors among the population of Community Health Agents (CHA). Methods This is a cross-sectional and analytical study conducted in the city of Montes Claros, MG, in which 674 CHA participated. Data were collected via a self-administered questionnaire that includes sociodemographic, economic, behavioral, occupational, and voice-use aspects based on the Screening Index for Voice Disorder (SIVD). Bivariate analysis was performed by Pearson's chi-square test and Poisson multiple regression with robust variance to verify the association between the variables. Results There was a high prevalence of vocal complaints, the most cited being dry throat, throat clearing, tiredness when talking, and hoarseness. We observed a significant association between female gender, lack of restful sleep, alcohol use, regular to very poor self-rated health, and anxiety. Conclusion There was a significant percentage of vocal complaints, and the associated factors found will guide actions to promote vocal and general health.

Fatores associados à sonolência diurna em estudantes de medicina / Factors associated with daytime sleepiness in medical students / Fatores asociados a somnolencia diurna em estudiantes de medicina

Objetivo: Avaliar os fatores associados à sonolência diurna em graduandos do curso de medicina do Norte de Minas. Método: estudo transversal, realizado com 231 acadêmicos que estavam frequentando o primeiro, sétimo e décimo-primeiro períodos de graduação em medicina. A sonolência diurna foi avaliada pela Escala de Sonolência Diurna de Epworth. Realizou-se a análise de regressão de Poisson para verificar os fatores associados à sonolência diurna. Resultados: níveis patológicos e muito patológicos de sonolência diurna foram observados, respectivamente, em 34,6% e 6,9% dos estudantes. A prevalência de sonolência diurna foi maior nos estudantes com Transtornos Mentais Comuns, Exaustão Emocional e Ineficácia Profissional, e menor naqueles que residem com os pais. Conclusão: a prevalência de sonolência diurna patológica nos estudantes mostrou-se elevada, e teve relação com transtornos mentais comuns, percepção de exaustão emocional e profissional, além do contexto com quem o estudante residia

Objective:To analyze the factors associated with daytime sleepiness in undergraduate medical students in the north of Minas Gerais. Method: a cross-sectional study was performed, involving 231 students from the first, seventh and eleventh medical undergraduate periods. Daytime sleepiness was assessed by the Epworth Daytime Sleepiness Scale. Poisson regression analysis was performed to verify the factors associated with daytime sleepiness. Results: pathological and very pathological levels of daytime sleepiness were observed, respectively, in 34.6% and 6.9% of the students. The prevalence of daytime sleepiness was higher in students who suffered Common Mental Disorders, Emotional Exhaustion and Professional Ineffectiveness, and lower among those who lived with their parents. Conclusion: the prevalence of pathological daytime sleepiness among the students was high, and was related to common mental disorders, perception of emotional and professional exhaustion, and the context with whom the student lived with

Objetivo: Evaluar los factores asociados con la somnolencia diurna en estudiantes universitarios de medicina del norte de Minas Gerais. Método: estudio transversal, realizado con 231 estudiantes que asistieron al primer, séptimo y undécimo período en medicina. La Escala de somnolencia diurna de Epworth evaluó la somnolencia diurna. Se realizó un análisis de regresión de Poisson para verificar los factores asociados con la somnolencia diurna. Resultados: se observaron niveles patológicos y muy patológicos de somnolencia diurna, respectivamente, en 34,6% y 6,9% de los estudiantes. La prevalencia de somnolencia diurna fue mayor en los estudiantes con trastornos mentales comunes, agotamiento emocional e ineficacia profesional, y menor en los estudiantes que viven con sus padres. Conclusión: la prevalencia de somnolencia patológica durante el día en los estudiantes fue alta y se relacionó con trastornos mentales comunes, percepción de agotamiento emocional y profesional y el contexto en el que residía el estudiante

Fatores associados à disfonia crônica autorreferida por professoras / Teachers' self-referred chronic dysphonia associated factors / Factores asociados a la disfonía crónica autoreferida por professoras

Objetivo: Caracterizar os aspectos sociodemográficos, organizacionais, estilo de vida, saúde-doença e vocais de professoras. Métodos: Estudo transversal e analítico envolvendo 146 docentes. Realizou-se análise bivariada por meio do teste qui-quadrado de Pearson. Resultados: A prevalência de alteração vocal crônica foi de 39,7%. As principais queixas autorreferidas foram: garganta seca, rouquidão, cansaço vocal, pigarro e falha na voz. Observou-se diferença estatisticamente significante para as variáveis: tempo de regência, ruído fora da escola, nenhum ou 1 copo de suco por dia, mais de uma dose alcoólica por vez, fala muito a demais no dia-a-dia, faltas e afastamento do trabalho por problema vocal, percepção de problema respiratório, diagnóstico médico de alergia respiratória, consulta médica para a voz e tratamento fonoaudiológico. Conclusão: Conhecer a prevalência e o perfil dos docentes com disfonia crônica são fatores importantes para atividades contínuas de promoção da saúde

Objective: The study's purpose has been to characterize the socio-demographic, organizational, lifestyle, health-disease and vocal aspects of teachers. Methods: It is both a cross-sectional and an analytical study that has involved 146 participating teachers. A bivariate analysis was performed through the Pearson's Chi-squared Test. Results: The prevalence of chronic vocal alteration was 39.7%. The main self-referred complaints were, as follows: dry throat, hoarseness, vocal fatigue, throat clearing and voice failure. A statistically significant difference was observed for the following variables: regency time, out-of-school noise, either none or one glass of juice per day, more than one alcoholic dose at a time, talks a lot on a daily basis, absences and work leave because of vocal issues, perception of respiratory problem, medical diagnosis of respiratory allergy, medical consultation for voice and speech-language therapy. Conclusion: Knowing both the prevalence and the profile of the chronic dysphonia bearing teachers are held as important factors for ongoing activities towards health promotion

Objetivo: Caracterizar los aspectos socio-demográficos, de organización, estilo de vida, salud-dolencia y vocales de las profesoras. Métodos: Estudio transversal y analítico involucrando 146 docentes. Se realizó un análisis bivariable por medio del test qui-cuadrado de Pearson. Resultados: Alteración vocal crónica 39,7%. Quejas autoreferidas: sequedad en la garganta, ronquera, cansancio vocal, irritación y fallo de la voz. Se observó una diferencia estadística significante para las variables: tiempo de desempeño, ruido fuera de la escuela, ningún ó 1 vaso de jugo diariamente, más de una dosis alcohólica al beber, hablar demasiado cotidianamente, faltas de descanso laboral por problema vocal, percepción del problema respiratorio, diagnóstico médico de alergia respiratoria, consulta médica para la voz y tratamiento fono-audiológico. Conclusión: Conocer el predominio y el perfil de docentes que padecen de disfonía crónica son factores importantes para las actividades continuadas de promoción de la salud

Desvantagem vocal em cantores líricos / Voice handicap in lyric singers / Desventaja vocal en cantantes líricos

Introdução: O Índice de Desvantagem no Canto Clássico (IDCC) auxilia o cantor sobre a percepção da sua voz e o impacto da produção vocal em sua vida profissional.Objetivo: Comparar a autopercepção da desvantagem vocal em cantores líricos e as variáveis sociodemográficas, queixas vocais, uso da voz falada e período dos sinais e sintomas vocais. Métodos: Pesquisa transversal e analítica, com trinta cantores líricos de uma escola pública de canto. Utilizou-se um questionário com dados sociodemográficos, sobre a voz e o IDCC. As variáveis independentes foram dicotomizadas e comparadas com os domínios incapacidade, desvantagem e defeito do IDCC pelo teste Mann-Whitney adotando um nível de significância estatística de 5% (p≤0,05). Resultados: O hábito de pigarrear foi o sintoma mais frequente. Os escores do IDCC apontaram maiores médias no domínio Defeito. Houve diferença estatisticamente significativa em todas as subescalas e no total entre aqueles com e sem cansaço vocal (Incapacidade p=0,003, Desvantagem p=0,028, Defeito p= 0,013, Total p=0,007); bem como quanto ao período de sinais e sintomas vocais entre sem problema/problema agudo e problema crônico (Desvantagem p=0,011, Defeito p=0,008, Total p=0,012); e entre aqueles sem e com queixas vocais (Defeito p=0,022; sendo limítrofe no Total p=0,053). Conclusão: os cantores líricos apresentaram desvantagem vocal dentre os que referem cansaço ao falar e/ou cantar, com queixas vocais e estas em um período considerado crônico.

Introduction: The Classical Singing Handicap Index (CSHI) assists the singer in the perception of his voice and the impact of the vocal production in his professional life. Objective: To compare the self-perception of the vocal handicap in lyric singers and the sociodemographic variables, the vocal complaints, the use of spoken voice and the period of the vocal signals and symptoms. Methods: Crosssectional and analytical research, with thirty lyric singers from a public singing school. A questionnaire with sociodemographic data about the voice and the CSHI was used. The independent variables were dichotomized and compared to the domains: disability, handicap and defect of the CSHI through the Mann-Whitney test adopting a level of statistical significance of 5% (p≤0.05). Results: The habit of clearing the throat was the most frequent symptom. The CSHI scores indicated higher averages in the Defect domain. There was a statistically significant difference in all the subscales and in the total among those with and without vocal fatigue (Inability p = 0.003, Handicap p = 0.028, Defect p = 0.013, Total p = 0.007); as well as the period of the vocal signs and symptoms between no problem/acute problem and chronic problem (Handicap p = 0.011, Defect p = 0.008, Total p = 0.012); and among those with and without vocal complaints (P = 0.022, being adjacent in the Total p = 0.053). Conclusion: The lyric singers presented vocal handicap among those who reported fatigue when speaking and/or singing, with vocal complaints and these ones in a period considered chronic.

Introducción: El índice de desventaja en el canto clásico (IDCC) auxilia al cantante en la percepción de su voz y en el impacto de la producción vocal en su vida profesional. Objetivo: Comparar la autopercepción de las desventajas vocales en los cantantes líricos y las variables sociodemográficas; quejas vocales, uso de la voz hablada y período de los signos y síntomas vocales. Métodos: Investigación transversal y analítica, con treinta cantantes líricos de una escuela pública de canto. Se utilizó una encuesta con datos sociodemográficos, sobre la voz y el IDCC. Las variables independientes fueron divididas y comparadas con los dominios Incapacidad, Desventaja y Defecto del IDCC por el test Mann-Whitney adoptando un nivel de significado estadístico de 5% (p≤0,05). Resultados: El hábito de carraspear fue el síntoma más frecuente. Los escores del IDCC apuntaron mayores promedios en el dominio Defecto. Se observó una diferencia estadísticamente significativa en todas las subescalas y en el total entre aquellos con y sin cansancio vocal (Incapacidad p=0,003, Desventaja p=0,028, Defecto p=0,013, Total p=0,007); así como en cuanto al período de los signos y síntomas vocales entre sin problema / problema agudo y problema crónico (Desventaja p=0,011, Defecto p=0,008, Total p=0,012); y entre aquellos sin y con quejas vocales (Defecto p=0,022, siendo limítrofe en el Total p=0,053). Conclusión: los cantantes líricos presentaron desventaja vocal entre los que mencionan cansancio al hablar y / o cantar, con quejas vocales en un período considerado crónico.

Self-Reported Acute and Chronic Voice Disorders in Teachers.

The present study aimed to identify factors associated with self-reported acute and chronic voice disorders among municipal elementary school teachers in the city of Montes Claros, in the State of Minas Gerais, Brazil. METHODS: The dependent variable, self-reported dysphonia, was determined via a single question, "Have you noticed changes in your voice quality?" and if so, a follow-up question queried the duration of this change, acute or chronic. The independent variables were dichotomized and divided into five categories: sociodemographic and economic data; lifestyle; organizational and environmental data; health-disease processes; and voice. Analyses of associated factors were performed via a hierarchical multiple logistic regression model. RESULTS: The present study included 226 teachers, of whom 38.9% reported no voice disorders, 35.4% reported an acute disorder, and 25.7% reported a chronic disorder. Excessive voice use daily, consuming more than one alcoholic drink per time, and seeking medical treatment because of voice disorders were associated factors for acute and chronic voice disorders. Consuming up to three glasses of water per day was associated with acute voice disorders. Among teachers who reported chronic voice disorders, teaching for over 15 years and the perception of disturbing or unbearable noise outside the school were both associated factors. CONCLUSIONS: Identification of organizational, environmental, and predisposing risk factors for voice disorders is critical, and furthermore, a vocal health promotion program may address these issues.

Quantificação dos ruídos sonoros em uma unidade de terapia intensiva neonatal / Measurement of acoustic noise levels in a neonatal intensive care unit / Cuantificación de niveles sonoros en una unidad de cuidados intensivos neonatales

A Unidade de Terapia Intensiva Neonatal (UTIN) é um ambiente cercado de pessoas e equipamentos com alarmes acústicos, sendo necessária a verificação do nível de ruídos e que os profissionais envolvidos tenham consciência dos efeitos nocivos que estes possam trazer para a equipe e os recém-nascidos. O objetivo deste estudo foi quantificar os ruídos sonoros existentes em uma UTIN. Trata-se de estudo descritivo, transversal,com abordagem quantitativa. Para a coleta de dados foi aferido o nível de pressão sonora no ambiente por meio de um sonômetro. Observou se que o valor médio dos decibéis encontrados foram Lmin = 48.5 dBA e Lmax = 90.9 dBA. Esses valores foram superiores ao recomendado pela ABNT e pela OMS, demonstrando necessidade de medidas urgentes e sistemáticas para o controle e redução do nível de pressão sonora na UTIN. O desenvolvimento de programas educativos de sensibilização, novas estratégias de capacitação da equipe multiprofissional e adoção de equipamentos que produzam menos ruídos são algumas medidas que possibilitarão a diminuição do nível de pressão sonora dentro dessa unidade.

The Neonatal Intensive Care Unit (NICU) is an environment filled with people and equipment with acoustic alarms. Measurement of acoustic noise levels in the NICU is important to raise awareness of the harmful effects of noise on neonates and NICU workers. The aim of this study was to measure acoustic noise levels in NICUs. This is a descriptive, cross-sectional, quantitative study. Noise levels were measured in NICUs with a precision sound-level meter. The mean minimum decibel level (Lmin) was 48.5 dBA, and the mean maximum decibel level (Lmax) was 90.9 dBA. These values are higher than recommended by the ABNT and the WHO. This indicates a need for urgent and systematic measures to control and reduce sound levels in the NICU. Some of these measures include implementing awareness-raising educational initiatives, developing new training approaches for the multidisciplinary team, and having policies to purchase less-noisy equipment.

La Unidad de Cuidados Intensivos Neonatales (UCIN) es un ambiente donde, aparte de personas, hay equipamiento con alarmas acústicas y porello debe medirse el nivel de ruido existente. Es importante que los profesionales sean conscientes de los efectos nocivos al personal y a los reciénnacidos. El objetivo de este estudio fue cuantificar los ruidos sonoros en una UCIN. Se trata de un estudio descriptivo transversal cuantitativo. Parala recogida de datos se midió el nivel de presión sonora en el ambiente a través de un sonómetro. Se observó que el valor promedio de decibeles encontrados fue Lmin = 48,5 dBA y Lmax = y 90,9 dBA. Estos valores fueron superiores a lo recomendado por la ABNT y la OMS, lo cual demuestra la necesidad de tomar medidas urgentes y sistemáticas para controlar y reducir el nivel de presión sonora en la UCIN. El desarrollo de programas educativos para crear conciencia, nuevas estrategias de capacitación de equipos multidisciplinarios y la adopción de equipamiento que generemenos ruido son algunas de las medidas necesarias para la reducción de los niveles sonoros en esa unidad.

Self-reported outcomes after hearing aid fitting in Minas Gerais, Brazil.

PURPOSE: To analyze the self-reported outcomes after hearing aid fitting among individuals in the northern region of Minas Gerais and associated factors. METHODS: A cross-sectional and analytical study with a random sample of adults and elderly attending the public health care service was conducted in the northern region of Minas Gerais (86 municipalities), Brazil. Study's participants answered International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires. Data were analyzed descriptively and analytically with Poisson regression analysis. RESULTS: We interviewed 272 adults and 112 individuals reported not using their hearing aids regularly. The mean of IOI-HA global score was lower than expected. The individual's relationship with their hearing aid (Factor 1) was worse than the individual's relationship with their environment (Factor 2). Lower global scores were statistically associated with no work. CONCLUSIONS: The observed scores for the study's population are lower than those recorded in other studies. The results suggest that there are limitations in the fitting and follow-up of individuals who received hearing aids.

Self-reported outcomes after hearing aid fitting in Minas Gerais, Brazil / Autoavaliação de resultados após adaptação com aparelhos auditivos em Minas Gerais, Brasil

PURPOSE: To analyze the self-reported outcomes after hearing aid fitting among individuals in the northern region of Minas Gerais and associated factors. METHODS: A cross-sectional and analytical study with a random sample of adults and elderly attending the public health care service was conducted in the northern region of Minas Gerais (86 municipalities), Brazil. Study's participants answered International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires. Data were analyzed descriptively and analytically with Poisson regression analysis. RESULTS: We interviewed 272 adults and 112 individuals reported not using their hearing aids regularly. The mean of IOI-HA global score was lower than expected. The individual's relationship with their hearing aid (Factor 1) was worse than the individual's relationship with their environment (Factor 2). Lower global scores were statistically associated with no work. CONCLUSIONS: The observed scores for the study's population are lower than those recorded in other studies. The results suggest that there are limitations in the fitting and follow-up of individuals who received hearing aids. .

OBJETIVO: Analisar os resultados da autoavaliação após adaptação com o aparelho de amplificação sonora individual entre indivíduos do norte de Minas Gerais e os fatores associados. MÉTODOS: Estudo transversal e analítico com amostra aleatória de adultos e idosos atendidos no serviço público de atenção à saúde auditiva, conduzido na região norte de Minas Gerais (86 municípios), Brasil. Os participantes do estudo responderam ao questionário International Outcome Inventory for Hearing Aids (IOI-HA). Os dados foram analisados descritivamente e analiticamente por meio da regressão de Poisson. RESULTADOS: Foram entrevistados 272 adultos e 112 indivíduos relataram não usar seus aparelhos auditivos regularmente. A média do escore global do IOI-HA foi abaixo do esperado. A relação do indivíduo com o seu aparelho (Fator 1) mostrou-se pior do que a relação do indivíduo com o ambiente (Fator 2). Escores globais mais baixos se mostraram estatisticamente associados com o fato de não trabalhar. CONCLUSÃO: Os escores observados para a população avaliada são menores do que os registrados em outros estudos. Os resultados sugerem que existem limitações no processo de adaptação e acompanhamento dos indivíduos que receberam aparelhos de amplificação sonora. .