Cuidado ás pessoas com agravos endocrinos e metabólicos / Care for people with endocrine and metabolic problems

O objetivo desse trabalho é descrever a sistematização da Assistência de Enfermagem a pessoas com agravos endócrinos e metabólicos pautado na teoria de Calista Roy. Metodologia: Trata-se de um relato de experiência através da aplicação da Sistematização da Assistência de Enfermagem (SAE), voltado para pessoas com agravos endócrinos e metabólicos no contexto hospitalar. Resultados e discussão: Foi aplicado a teoria da adaptação nas seis fases da Teoria de Calista Roy e foi elaborado diagnósticos de enfermagem para os quatro modos de adaptação: fisiológico, interdependência, autoconceito e função de papel. Considerações finais: Ao aplicar a SAE no indivíduo com agravos endócrinos e metabólicos a enfermeira deve realizá-lo em todas as suas etapas, e utilizar os protocolos para oferecer um cuidado holístico e integral, visando a promoção da saúde, prevenção de risco potencial e adaptação diante das necessidades em saúde.(AU)

The aim of this study is to describe the systematization of nursing care for people with endocrine and metabolic disorders, based on Calista Roy's theory. Methodology: This is an experience report on the application of the Systematization of Nursing Care (SNC) to people with endocrine and metabolic disorders in a hospital setting. Results and discussion: The theory of adaptation was applied in the six phases of Calista Roy's theory and nursing diagnoses were drawn up for the four modes of adaptation: physiological, interdependence, self-concept and role function. Final considerations: When applying the SNC to individuals with endocrine and metabolic disorders, the nurse must carry it out in all its stages, and use the protocols to offer holistic and comprehensive care, aimed at promoting health, preventing potential risks and adapting to health needs.(AU)

El objetivo de este estudio es describir la sistematización de los cuidados de enfermería a personas con trastornos endocrinos y metabólicos, basándose en la teoría de Calista Roy. Metodología: Se trata de un informe de experiencia sobre la aplicación de la Sistematización de los Cuidados de Enfermería (SNC) a personas con trastornos endocrinos y metabólicos en un entorno hospitalario. Resultados y discusión: Se aplicó la teoría de la adaptación en las seis fases de la teoría de Calista Roy y se elaboraron diagnósticos de enfermería para los cuatro modos de adaptación: fisiológica, interdependencia, autoconcepto y función de rol. Consideraciones finales: Al aplicar el SNC a individuos con trastornos endocrinos y metabólicos, la enfermera debe llevarlo a cabo en todas sus fases, y utilizar los protocolos para ofrecer cuidados holísticos e integrales, dirigidos a promover la salud, prevenir riesgos potenciales y adaptarse a las necesidades de salud.(AU)

Factors Associated with the Lifestyle of Pediatric Healthcare Professionals during the COVID-19 Pandemic.

The objective of this study was to analyze the association between sociodemographic and occupational variables with the lifestyle of health professionals in pediatric units during the COVID-19 pandemic. A cross-sectional study was conducted with 407 health professionals working in four pediatric health units in the State of Bahia, northeast Brazil. The Fantastic Lifestyle Questionnaire and a questionnaire with sociodemographic and employment variables self-applied via Google Forms were used. The final binary logistic regression models revealed significant associations between those who received 3 to 5 minimum wages, without a marital relationship and with more than one employment relationship. Data suggest that these sociodemographic and occupational profiles are more exposed to risky lifestyle behaviors. The findings of this study demonstrated the need for greater attention to the health of health professionals in the pediatric field, as well as the promotion of initiatives that seek to value the work of these professionals and reduce the damage caused to their lifestyle, especially in a pandemic scenario.

Association between burnout syndrome and obesity: A cross-sectional population-based study.

BACKGROUND: Burnout Syndrome (BS) is a response of organism against long-lasting exposure to occupational stressors. Those affected usually have comorbidities, as well as cardiovascular and metabolic problems. OBJECTIVE: Estimating the association between BS and obesity in primary health care nurses of in the state of Bahia, Brazil. METHODS: Population-analytical, cross-confirmatory, integrated and multicenter study, conducted with a random sample of primary health care nursing professionals in 43 municipalities from 07 mesoregions of Bahia, Brazil. This study was funded by the Brazilian Board for Scientific and Technological Development. The independent variable (BS) was evaluated by using the Maslach Burnout Inventory (MBI) scale, and the dependent one (obesity) was based on the Body Mass Index (BMI)≥30. Effect modification and confounding factors were verified by crude, stratified, and multivariate analysis. RESULTS: The prevalence of BS and obesity was 17.7% and 12.7%, respectively. BS was statistically associated with obesity, even after adjustment (RPa: 1.85; CI 95% 1.11-3.06) per gender, age, physical activity, healthy eating, satisfaction with occupation, another job, night shift, primary health care (PHC) time, and working conditions. Effect-modifying variables were not identified. CONCLUSIONS: The specialized literature points out a path to the association identified here. New studies on the subject are relevant and should have more robust methodologies so that the path of causality is better clarified. In addition, occupational health programs become an alternative to control stress and, therefore, its complications, such as burnout and other health aggravations.

Rural work and COVID-19: challenges and proposals for the prevention of damages.

The COVID-19 pandemic has highlighted the inequalities in health care access in Brazil, exarcerbating vulnerabilities and social determinants of health. Inequality is part of the context of rural populations, especially rural workers and family and subsistence farmers due to both the direct consequences of work activity and the unfavorable socioeconomic context, especially regarding service provision, the guaranteeing of rights, and the coordination of care networks. This article reviews challenges to the health of these workers and outlines proposals for disease prevention in the context of the COVID-19 pandemic.

Apandemia de covid-19 no mundo trouxe à tona as desigualdades vivenciadas no acesso à saúde no Brasil, escancarando as vulnerabilidades e os determinantes sociais de saúde. É nesse ínterim de iniquidades que as populações rurais se inserem, em especial trabalhadores e trabalhadoras rurais e membros da agricultura familiar e de subsistência, tanto pelas consequências diretas da atividade laboral quanto pelo contexto socioeconômico desfavorável, especialmente no que diz respeito a oferta de serviços, garantia de direitos e articulação das redes de assistência. Frente a isso, o presente trabalho discute os desafios relacionados à saúde desses trabalhadores e traça propostas para a prevenção de agravos da referida população no contexto da pandemia de covid-19.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE: Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Association between Metabolic Syndrome and professional category: a cross-sectional study with Nursing professionals. / Associação entre síndrome metabólica e categoria profissional: estudo transversal com profissionais de Enfermagem.

OBJECTIVE: to evaluate the association of Metabolic Syndrome and its components among Primary Health Care Nursing professionals in the state of Bahia, Brazil, according to professional category. METHOD: a cross-sectional, population-based and multicenter study conducted with 1,125 Nursing professionals. The independent variable was the professional category, dichotomized into technical and higher education levels. The outcome was Metabolic Syndrome following criteria from the National Cholesterol Education Program Adult Treatment Panel III based on anthropometric measurements and blood samples. The statistical analysis was performed by calculating the prevalence ratios and using Pearson's Chi-square test. RESULTS: the prevalence of Metabolic Syndrome was higher in the technical level category (PR=1.64; CI=1.29 - 2.06; p≤0.01). When compared to Nurses, these professionals were older, had lower incomes, worked more on duty and performed less physical activity on a regular basis. Among the Nurses, the most prevalent component was altered cholesterol (40.5%) and among the Nursing Technicians/Assistants, it was abdominal obesity (47.3%). CONCLUSION: the association between the Nursing category and Metabolic Syndrome was evident, with higher occurrence among technical level professionals.

Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study.

Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study's findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.

Effect of immunonutrition on serum levels of C-reactive protein and lymphocytes in patients with COVID-19: a randomized, controlled, double-blind clinical trial.

INTRODUCTION: Introduction: patients with COVID-19 undergo changes in leukocyte count, respiratory disorders, and an increase in inflammatory substances. To improve the inflammatory condition, some nutrients can be used, including arginine, omega-3 fatty acids and nucleotides. This study aims to evaluate how oral immunonutrient supplements affects serum C-reactive protein (CRP) levels and lymphocyte count in patients with COVID-19. Methods: in this double-blind clinical trial, we randomized 43 adult patients with COVID-19 to receive a standard high-protein normocaloric supplement (control) or an immunonutrient-enriched supplement (experiment) for 7 days. The primary outcome was to evaluate changes in total lymphocyte count and serum level of CRP. The assessment of risk and nutritional status of these patients was also performed. Results: forty-three patients with mean age of 41.5 (± 1.8) years were followed up, 39.5 % of them women. The mean body mass index was 27.6 (± 0.8) kg/m² and 58.1 % had low nutritional risk. In the experiment group, there was a CRP reduction of 23.6 (± 7.5) mg/L, while in the control branch the decrease was 14.8 (± 12.1) mg/L (p = 0.002). There was an increase in lymphocytes in the experiment group (+367.5 ± 401.8 cells/mm³) and a reduction in the control group (-282.8 ± 327.8 cells/mm³), although there was no statistical significance (p = 0.369). Relative risk (RR) of treatment in reducing CRP by 30 % or more was 4.45 (p < 0.001; 95 % CI, 1.79-11.07). RR in increasing lymphocyte count by 30 % or more was 1.28 (p = 0.327; 95 % CI, 0.67-2.45). Conclusion: we conclude that immunonutrient supplements seem to reduce CRP levels more than standard high-protein normocaloric supplements.

INTRODUCCIÓN: Introducción: los pacientes con COVID-19 sufren cambios en el recuento de leucocitos, trastornos respiratorios y aumento de sustancias inflamatorias. Para mejorar la condición inflamatoria se pueden usar algunos nutrientes, como la arginina, los ácidos grasos omega-3 y los nucleótidos. Este estudio tiene como objetivo evaluar cómo los suplementos de inmunonutrientes orales afectan a los niveles séricos de proteína C-reactiva (PCR) y al recuento de linfocitos en pacientes con COVID-19. Métodos: en este ensayo clínico doble ciego, aleatorizamos a 43 pacientes adultos con COVID-19 para recibir un suplemento normocalórico estándar alto en proteínas (control) o un suplemento enriquecido con inmunonutrientes (experimento) durante 7 días. El resultado primario fue evaluar los cambios en el recuento total de linfocitos y el nivel sérico de PCR. También se realizó la evaluación del riesgo y el estado nutricional de estos pacientes. Resultados: cuarenta y tres pacientes con edad media de 41,5 (± 1,8) años fueron seguidos, el 39,5 % de ellos mujeres. El índice de masa corporal medio fue de 27,6 (± 0,8) kg/m² y el 58,1 % tenían bajo riesgo nutricional. En el grupo experimental hubo una reducción de la PCR de 23,6 (± 7,5) mg/L, mientras que en la rama de control la disminución fue de 14,8 (± 12,1) mg/L (p = 0,002). Hubo un aumento de linfocitos en el grupo experimental (+367,5 ± 401,8 células/mm³) y una reducción en el grupo de control (-282,8 ± 327,8 células/mm³), aunque no hubo significación estadística (p = 0,369). El riesgo relativo (RR) del tratamiento para reducir la PCR en un 30 % o más fue de 4,45 (p < 0,001; IC 95 %: 1,79-11,07). El RR en el aumento del recuento de linfocitos en un 30 % o más fue de 1,28 (p = 0,327; IC 95 %: 0,67-2,45). Conclusión: se concluye que los suplementos de inmunonutrientes parecen reducir los niveles de PCR más que los suplementos normocalóricos estándar altos en proteína.

Associação entre síndrome metabólica e categoria profissional: estudo transversal com profissionais de Enfermagem / Association between Metabolic Syndrome and professional category: a cross-sectional study with Nursing professionals / Asociación entre síndrome metabólico y categoría profesional: estudio transversal con profesionales de enfermería

Resumo Objetivo: avaliar a associação da Síndrome Metabólica e dos seus componentes entre os profissionais de Enfermagem da Atenção Primária à Saúde do estado da Bahia, Brasil, segundo a categoria profissional. Método: estudo transversal, populacional e multicêntrico conduzido com 1.125 profissionais de Enfermagem. A variável independente foi a categoria profissional, dicotomizada em nível técnico e superior de ensino. O desfecho foi a Síndrome Metabólica seguindo os critérios da National Cholesterol Education Program Adult Treatment Panel III, a partir de aferições antropométricas e de amostras sanguíneas. A análise estatística deu-se pelo cálculo das razões de prevalência e pelo Teste Qui-quadrado de Pearson. Resultados: a prevalência da Síndrome Metabólica foi maior na categoria de nível técnico (RP=1,64; IC 1,29 - 2,06; p≤0,01). Estes profissionais quando comparados com os Enfermeiros eram mais velhos, tinham renda inferior, trabalhavam mais em regime de plantão e realizavam menos atividades físicas de maneira regular. Entre Enfermeiros, o componente mais prevalente foi o colesterol alterado (40,5%); entre Técnicos de Enfermagem/Auxiliares, a obesidade abdominal (47,3%). Conclusão: ficou evidente a associação entre categoria de Enfermagem e Síndrome Metabólica, cuja ocorrência foi maior entre profissionais de nível técnico.

Abstract Objective: to evaluate the association of Metabolic Syndrome and its components among Primary Health Care Nursing professionals in the state of Bahia, Brazil, according to professional category. Method: a cross-sectional, population-based and multicenter study conducted with 1,125 Nursing professionals. The independent variable was the professional category, dichotomized into technical and higher education levels. The outcome was Metabolic Syndrome following criteria from the National Cholesterol Education Program Adult Treatment Panel III based on anthropometric measurements and blood samples. The statistical analysis was performed by calculating the prevalence ratios and using Pearson's Chi-square test. Results: the prevalence of Metabolic Syndrome was higher in the technical level category (PR=1.64; CI=1.29 - 2.06; p≤0.01). When compared to Nurses, these professionals were older, had lower incomes, worked more on duty and performed less physical activity on a regular basis. Among the Nurses, the most prevalent component was altered cholesterol (40.5%) and among the Nursing Technicians/Assistants, it was abdominal obesity (47.3%). Conclusion: the association between the Nursing category and Metabolic Syndrome was evident, with higher occurrence among technical level professionals.

Resumen Objetivo: evaluar la asociación que hay entre el Síndrome Metabólico y sus componentes y los profesionales de Enfermería de la Atención Primaria de Salud en el estado de Bahía, Brasil, según la categoría profesional. Método: estudio transversal, de base poblacional y multicéntrico realizado con 1.125 profesionales de Enfermería. La variable independiente fue la categoría profesional, dicotomizada en niveles de educación técnica y superior. El resultado fue Síndrome Metabólico siguiendo los criterios del National Cholesterol Education Program Adult Treatment Panel III a partir de mediciones antropométricas y muestras de sangre. El análisis estadístico se realizó calculando las razones de prevalencia y utilizando la prueba de Chi-cuadrado de Pearson. Resultados: la prevalencia de Síndrome Metabólico fue mayor en la categoría de nivel técnico (RP=1,64; IC 1,29 - 2,06; p≤0,01). Dichos profesionales tenían mayor edad, menor ingreso, más guardias y realizaban menos actividad física de forma regular que los Enfermeros. En los Enfermeros, el componente más prevalente fue el colesterol alterado (40,5%); en los Técnicos en Enfermería/Auxiliares fue la obesidad abdominal (47,3%). Conclusión: fue evidente la asociación entre la categoría de Enfermería y el Síndrome Metabólico, fue mayor en los profesionales de nivel técnico.

The Prevalence of Abdominal Adiposity among Primary Health Care Physicians in Bahia, Brazil: An Epidemiological Study.

BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.

Relationship between the COVID-19 pandemic, binge eating, and mental suffering in health professionals in Brazil: a cross-sectional study.

Introduction: The high levels of anxiety, stress, and depression produced by the global Coronavirus disease 2019 pandemic could trigger eating disorders. Health professionals are more exposed to these changes due to their work environment. Objectives: To evaluate the relationship between the COVID-19 pandemic and the onset of binge eating disorder and psychiatric disorders in Brazilian health professionals. Methods: This descriptive, prospective, cross-sectional study interviewed 219 Brazilian health professionals between June and October 2020 using an online questionnaire. The 7-Item Binge Eating Disorder Screener was used to diagnose binge eating disorder. The Self-Reporting Questionnaire was used to assess psychiatric disorders. The statistical analysis included calculation of absolute frequency, relative frequency, mean and standard deviation. Contingency coefficient C was used to determine the association between the variables. Results: A total of 35 (16%) participants reported symptoms related to binge eating disorder, while 131 (59.8%) reported psychiatric symptoms. There was an association between binge eating disorder, psychiatric disorders, and body mass index. Conclusions: Our findings suggest the onset of psychiatric disorders and binge eating disorders in these professionals and that elevated body mass index is directly associated with these disorders.

Burnout syndrome and metabolic syndrome: a cross-sectional population-based study.

In the population of Primary Health Care Nursing (PHC) professionals, the association between Burnout Syndrome (BS) and Metabolic Syndrome (MS) has not been investigated. The objective was to evaluate the association between BS and MS among PHC Nursing Professionals. A cross-sectional, multicenter, population-based study was conducted in the state of Bahia, Brazil, with 1,125 professionals. The prevalence of BS and MS corresponded to 18.3% and 24.4%, respectively. The prevalence in women of BS was 16.4% and of MS 23.7%, in men 31.6% for BS and 29.4% for MS. Men with BS are 3.23 times more likely to develop MS, and women 1.48 times more. BS was associated between men and women and exhibited a good discriminatory predictive power.

Association between metabolic syndrome and work: an integrative review of the literature.

The aim of this study was to highlight the association between occupational aspects and the occurrence of metabolic syndrome among various occupational groups. This is an integrative review of the literature that included articles indexed in the following databases: LILACS, SciELO, PubMed, and CINAHL. We evaluated 32 articles, most of which were published in Englishlanguage medical journals and with level 4 scientific evidence. The occupational aspects most commonly reported as associated with metabolic syndrome were occupation, work shift, and occupational stress. Our results indicated that occupational aspects could negatively interfere with workers' health; more robust longitudinal studies should contribute to further uncovering the reported associations.

Prevalence and Factors Associated with Burnout Syndrome among Primary Health Care Nursing Professionals: A Cross-Sectional Study.

The objective of the study was to evaluate the prevalence and factors associated with Burnout Syndrome (BS) in Primary Health Care (PHC) nursing professionals from the state of Bahia, Brazil. A multicentre, cross-sectional population-based study was conducted in a cluster sample among 1125 PHC Nursing professionals during the years 2017 and 2018. We used a questionnaire that included sociodemographic, labor and lifestyle variables and the Maslach Burnout Inventory scale to identify BS. The associations were evaluated using a robust Poisson regression with the hierarchical selection of the independent variables. The prevalence of BS was 18.3% and the associated factors were ethnicity (prevalence ratio (PR) = 0.62, confidence interval (CI) 95% = 0.47-0.83), residence (PR = 2.35, CI 95% = 1.79-3.09), economic situation (PR = 1.40, CI 95% = 1.06-1.86), satisfaction with current occupation (PR = 1.75, CI 95% = 1.31-2.33), (PR = 1.60, CI 95% = 1.23-2.08), rest (PR = 1.83, 95% CI = 1.41-2.37), technical resources and equipment (PR = 1.37, CI 95% = 1.06-1.77), night shift (PR = 1.49, CI 95% = 1.14-1.96), physical activity practice (PR = 1.72; CI 95% = 1.28-2.31), smoking (PR = 1.82, CI 95% = 1.35-2.45), and satisfaction with physical form (PR = 1.34, CI 95% = 1.01-179). Strategies are needed to prevent BS, with an emphasis on implementing worker health programs in the context of PHC.

Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study.

This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.

Produção de mamografias no âmbito do sistema único de saúde / Production of mammograms within the national health service

Entre as modalidades de atenção previstas para o controle do câncer de mama está a detecção precoce pela realização de mamografia. O objetivo do estudo foi caracterizar segundo informações das usuárias e do exame a produção de mamografias no âmbito do Sistema Único de Saúde. Trata-se de estudo transversal descritivo acerca dos registros das mamografias realizadas no território brasileiro entre 2009 e 2014, cujas informações constavam no Sistema de Informação do Controle do Câncer de Mama. Ficou evidenciada baixa cobertura na região Norte do Brasil. Observou-se percentual maior de realização para as mulheres brancas e que tinham ensino fundamental incompleto. Em relação às categorias do Breast Imaging Reporting and Data System, os achados benignos foram os mais recorrentes entre as mulheres brasileiras. A recomendação de conduta mais frequente foi realização de mamografia em dois anos. O conhecimento de variáveis sociodemográficas no rastreamento de câncer de mama pode identificar grupos populacionais de risco para a realização de tal prática.

Early detection of breast cancer by mammography is one of the care modalities for the control of breast cancer. Current transversal and descriptive study analyzes the production of mammograms within the NHS, following information by patients and tests, and investigates the registration of mammograms in Brazil between 2009 and 2014. Information was obtained from the Information System for the Control of Breast Cancer. Low covering rate occurred in northern Brazil. A higher percentage was evidenced for white females with incomplete basic schooling. With regard to categories within the Breast Imaging Reporting and Data System, benign results were high among Brazilian females. More frequent behavior within a two-year period was recommended. Knowledge on socio-demographic variables in the screening of breast cancer may identify risk groups for the undertaking of such procedure.

Sentimentos de mulheres com câncer de mama após mastectomia / Feelings of women with breast cancer after mastectomy

Objetivo: conhecer os sentimentos de mulheres com câncer de mama após mastectomia. Método: estudo descritivo, com abordagem qualitativa, conduzido junto a cinco mulheres vinculadas às Unidades de Saúde da Família. Os dados foram coletados mediante entrevista semiestruturada e analisados por meio da técnica de Análise de conteúdo na modalidade Análise Categorial. Resultados: foram definidas duas categorias > e >. Conclusão: o estudo demonstrou que os sentimentos vivenciados pelas participantes a princípio são de surpresa e de desespero diante da doença, e quando se deparam com a mastectomia como forma de tratamento, surgem tristeza, negação, depressão, ansiedade e, por fim, a aceitação.

Síndrome de burnout em trabalhadores de enfermagem da atenção básica à saúde / Burnout syndrome in nursing workers of the primary health care

Objetivo: estimar a prevalência da Síndrome de Burnout entre trabalhadores de enfermagem da Atenção Básicaà Saúde do município de Pojuca, Bahia, Brasil. Método: estudo transversal, descritivo, vinculado a um projetomulticêntrico, conduzido nas 12 Unidades de Saúde da Família, com 11 (39,3%) enfermeiros e 17 (60,7%) técnicos eauxiliares de enfermagem. Utilizou-se o Maslach Burnout Inventory. Resultados: apresentaram alto nível de ExaustãoEmocional 28,6% dos participantes; alto nível de Despersonalização foi apresentado por 21,5%; 46,4% expressaramalto nível de Reduzida Realização Profissional. A prevalência da síndrome apresentou um percentual relevante(7,1%), ao considerar que este diagnóstico pode ser prevenido. Conclusões: a prevalência de percentual relevanteda Síndrome de Burnout entre trabalhadores de enfermagem no município estudado exige a implementação demedidas para a prevenção no ambiente laboral, com um programa de saúde ocupacional que favoreça a promoçãoe o acompanhamento da situação de saúde desses profissionais.

Objective: to estimate the prevalence of Burnout Syndrome among the nursing workers of the primary health care inthe municipality of Pojuca, Bahia, Brazil. Method: cross-sectional descriptive study, linked to a multicenter projectconducted in 12 Family Health Units, with 11 (39.3%) nurses and 17 (60.7%) technicians and nursing assistants.We used the Maslach Burnout Inventory. Results: 28.6% of participants had high levels of emotional exhaustion;high level of depersonalization was presented by 21.5%; 46.4% expressed a high level of Reduced ProfessionalAccomplishment. The prevalence of the syndrome showed a significant percentage (7.1%), considering that thisdiagnosis can be prevented. Conclusions: the prevalence of relevant percentage of the Burnout Syndrome among nursing workers in the city studied requires the implementation of measures for prevention in the workplace, with anoccupational health program to encourage the promotion and monitoring of the health status of these professionals.

Objetivo: estimar la prevalencia del Síndrome de Burnout entre trabajadores de enfermería de la Atención Básica ala Salud del municipio de Pojuca, Bahia, Brasil. Método: estudio transversal, descriptivo, vinculado a un proyectomulticéntrico, conducido en las 12 Unidades de Salud de la Familia, con 11 (39,3%) enfermeros y 17 (60,7%)de técnicos y auxiliares de enfermería. Se utilizó el Maslach Burnout Inventory. Resultados: presentaron altonivel de Cansancio Emocional 28,6% de los participantes; alto nivel de Despersonalización fue presentado por21,5%; 46,4% expresaron alto nivel de Reducida Realización Profesional. La prevalencia del síndrome presentó unporcentual relevante (7,1%), al considerar que este diagnóstico puede ser prevenido. Conclusiones: la prevalencia deporcentual relevante del Síndrome de Burnout entre trabajadores de enfermería en el municipio estudiado exige laimplementación de medidas para la prevención en el ambiente laboral, con un programa de salud ocupacional quefavorezca la promoción y el acompañamiento de la situación de salud de esos profesionales.