Modelos de comunicação e uso de impressos na educação em saúde: uma pesquisa bibliográfica / Communication models and use of printed materials in healthcare education: a bibliographic survey / Modelos de comunicación y uso de impresos en educación en salud: una pesquisa bibliográfica

O artigo apresenta os resultados de uma pesquisa bibliográfica sobre o uso de materiais impressos na educação em saúde, enfocando os modelos de comunicação, as representações dos usuários e as dinâmicas da seleção de conteúdos e de avaliação. Realizou-se uma análise de 11 artigos pesquisados a partir da base Scielo. Nessa análise, os artigos apontam que a comunicação se caracteriza predominantemente pelo modelo unilinear e pela impessoalidade. Os receptores são considerados meros consumidores de conceitos científicos. Na maioria das vezes, os profissionais de saúde são os únicos responsáveis pela seleção dos conteúdos. Nos artigos pesquisados pode-se encontrar um conflito entre a perspectiva dos seus autores (dialógica) e a dos produtores dos impressos (unilinear).

This paper presents the results from a bibliographic survey on the use of printed materials in healthcare education. The focus was on communication models, users' representations and the dynamics of content selection and assessment. An analysis was conducted on 11 articles surveyed in the Scielo database. In this analysis, the articles indicated that the communication was characterized by a linear model and impersonality. The receivers were considered to be mere consumers of scientific concepts. In most cases, health professionals were the only people responsible for the selection of content. In the articles surveyed, a conflict between their authors' perspective (dialogical) and the printed materials producers' perspective (unilinear) can be found.

El artículo presenta los resultados de una encuesta sobre el uso de materiales impresos en la educación en la salud, con enfoque sobre los modelos de comunicación, las representaciones de los usuarios y las dinámicas de selección de contenidos y de avaliación. Se realizó un análisis de 11 artículos de búsquedas en la base SciELO. En este análisis, los artículos indican que la comunicación se caracteriza por el modelo unilinear y la impersonalidad. Los receptores son considerados meros consumidores de conceptos científicos. En la mayoría de los casos, el profesional de la salud es el único responsable de la selección de contenido. En los artículos pesquisados se encuentra un conflicto entre la perspectiva de sus autores (dialógica) y la de los productores de los impresos (unilinear).

[Health education in schools in Argentina: an art contest as a motivating activity]. / Educación para la salud en escuelas argentinas: concurso de plástica como actividad motivadora.

The purpose of this study was to plan health education efforts that integrate the health and education sectors. From March to November 2004, an art contest was held for 7th-9th grade students in 109 schools in 11 of Argentina's provinces. The contest allowed improvements in knowledge to be measured and adjustments to be made to the curriculum. The students created works of art featuring tuberculosis. To evaluate knowledge acquired, two provinces were chosen at random. Student knowledge had increased from 67.2% to 96.4%. The administrators and teachers testified to the usefulness of the materials developed. These results show that when the efforts of health and education sectors are coordinated and the appropriate materials are leveraged, the efforts of educators can be substantially bolstered.

Educación para la salud en escuelas argentinas: concurso de plástica como actividad motivadora / Health education in schools in Argentina: an art contest as a motivating activity

The purpose of this study was to plan health education efforts that integrate the health and education sectors. From March to November 2004, an art contest was held for 7th–9th grade students in 109 schools in 11 of Argentina’s provinces. The contest allowed improvements in knowledge to be measured and adjustments to be made to the curriculum. The students created works of art featuring tuberculosis. To evaluate knowledge acquired, two provinces were chosen at random. Student knowledge had increased from 67.2% to 96.4%. The administrators and teachers testified to the usefulness of the materials developed. These results show that when the efforts of health and education sectors are coordinated and the appropriate materials are leveraged, the efforts of educators can be substantially bolstered.

[Construction workers' reactions to educational materials: a debate on relations between health and work]. / Estudo de recepção de impressos por trabalhadores da construção civil: um debate das relações entre saúde e trabalho.

This study focuses on the reactions of construction workers to educational materials (posters, folders, and leaflets) produced by the Brazilian Ministries of Health and Labor. The authors conducted two focal groups at construction sites in the city of Rio de Janeiro to analyze four educational materials, employing thematic analysis. The article presents the workers' perspective on the themes discussed in the leaflets, classified in two groups of meaning: health and social control. They go on to discuss how workers' display an expanded vision of health to the extent that it includes social determinants of the health-disease process. The study identified the workers' limited participation in work-process surveillance activities and their lack of knowledge concerning workers' health measures adopted by the Ministry of Health. The authors conclude that the analysis of educational materials by their target public represents a privileged place for negotiating meanings and grasping ways of life in specific groups. They suggest educational activities using leaflets as a means to motivate critical analysis of the health-disease process.

[How to increase the involvement of casualty patients in their treatments: efficacy of some informative posters]. / Cómo aumentar la implicación del paciente de urgencias en su tratamiento? Eficacia de unos pósters informativos.

OBJECTIVE: To determine whether posters/leaflets increase doctors' information on the allergies and on the medication their patients are taking and patients' understanding of their treatment. DESIGN: First stage: multi-centre transversal descriptive study. Second stage: intervention with control and without randomisation. SETTING: Primary care medical emergency services (MES). PARTICIPANTS: MES patients under prescribed drug treatment. INTERVENTIONS: Use of posters/leaflets. MAIN MEASUREMENTS: 1) Proportion of patients for whom the doctor was ignorant of allergies to drugs or of accompanying medication. 2) Proportion of prescriptions in which patients understood the dosage of the medication prescribed. SOURCE: ad hoc questionnaire to patients. ANALYSIS: chi2 test (category variables). In some cases, the Breslow-Day and Tarone tests were conducted. RESULTS: Total patients included, 1233; 1766 prescriptions analysed; 53.4% women. Mean age: 29+/-18 years old. 1) Doctor's understanding of accompanying medication: at the second stage, drop of 25.5% (95% CI, 33.5-17.5) for intervention group versus drop of 12.5% (95% CI, 19.8-5.2) for control group, in the number of patients for whom the doctor did not know the medication (P=.024). 2) Patient's understanding of dosage: at the second stage, increase of 16.8% (95% CI, 9.8-23.8) for intervention group, versus a decrease of 1% in control group, in the medicines whose dosage the patient was aware of (P<.001). CONCLUSIONS: The dissemination of posters/leaflets was effective in increasing patients' knowledge of their medication's dosage and doctors' understanding of questions affecting prescription.

Health care providers' opinions on intimate partner violence resources and screening in a pediatric emergency department.

OBJECTIVES: The American Academy of Pediatrics has called upon pediatricians to routinely screen for intimate partner violence (IPV) as an active means by which to prevent child abuse. The pediatric emergency department (ED) is one potentially important site to screen and to provide women with IPV resources. This cross-sectional questionnaire investigated pediatric health care providers' (HCPs') opinions about displaying IPV posters and performing IPV screening in a pediatric ED. METHODS: This cross-sectional survey was conducted in the ED of an urban, academic, tertiary care children's hospital that serves approximately 70,000 children each year. A convenience sample of 151 HCPs, defined as any person who provided medical care, including physicians, nurses, paramedics, and respiratory therapists, in the pediatric ED was surveyed using a 4-item questionnaire, designed by investigators, about their views regarding newly displayed IPV posters and resource cards, their opinions about universal IPV screening, and their personal use of the IPV materials. Between June and August 2004, surveys were distributed, along with return envelopes to be placed in a sealed box, to HCPs during their shifts in the ED. RESULTS: Of the 158 distributed surveys, 151 (96%) were returned. Of the sample, 30% were physicians, 53% were RNs, 10% were paramedics/emergency medical technicians, and 7% were other HCPs. Pediatric ED providers supported both IPV resource information and routine screening. Female providers were more likely than men to support the IPV posters. Five percent of the sample took IPV resource information for themselves or for later use with patients. CONCLUSIONS: Our pediatric ED's providers' endorsement of IPV screening and of the presence of IPV posters demonstrates support for and recognition of the problem of IPV in their patients' families.

Ask your doctor: the construction of smoking in advertising posters produced in 1946 and 2004.

This paper examines two full-page A3 poster advertisements in mass magazines produced at two time points over a 60-year period depicting smoking and its effects, with particular relation to lung cancer. Each poster represents the social and cultural milieu of its time. The writings of Foucault are used to explore the disciplinary technologies of sign systems as depicted in the two posters. The relationships between government, tobacco companies and drug companies and the technologies of production are examined with regard to the development of smoking cessation strategies. The technologies of power are associated with the constructions of risk and lifestyles. The technologies of the self locate smokers as culpable subjects responsible for their individual health. Finally, the meshing of these technologies places the doctor in the frame as "authoritative knower" and representative of expert systems.

[Health education: teaching about American tegumentary leishmaniasis]. / Educação em saúde: ensinando sobre a leishmaniose tegumentar americana.

Knowledge on the circulation of American tegumentary leishmaniasis (ATL) and perception by the local population are highly relevant for developing a control program, since they mobilize the community for effective health measures. This work aimed to orient primary school teachers and pupils (grades 1 through 4) in the public school system in Maricá, Rio de Janeiro State, Brazil, on ATL, using talks, posters, and leaflets with an interactive approach. Talks were given in seven municipal schools, and activities were held with 1,314 pupils and 56 teachers. Leaflets were distributed to the pupils with activities to help consolidate the content. Two months later one school was chosen for post-evaluation. Of the 213 pupils who had attended the talk, 198 answered a questionnaire, of whom 178 (89.9%) could remember the disease and 125 (63.1%) provided correct answers on transmission. Thus, informed children and teachers can function as information disseminators in health within their community and are therefore capable of contributing to control of endemic diseases.

Cost-effectiveness analysis of recruitment strategies in a community-based intervention study of HIV-infected persons.

This paper describes and evaluates recruitment methods used to reach adults with HIV infection and to enroll eligible candidates in a randomized trial of aerobic exercise. Potential participants residing in the metropolitan Washington DC area were recruited from January 1994 to December 1996. The yield and associated cost of clinic centre site-visit (CSV) recruitment are compared to similar outcomes for community-based (CB) recruitment strategies, which consisted of presentations to local groups, mail/phone canvasses of caregivers, neighbourhood network promotion, public site postings and print media notices. Of 833 HIV infected adults ascertained during the recruitment phase as prospective study candidates, 66.7% were initially contacted during CSV recruitment. The remainder, 33.3% were CB recruits. The percentage of screened candidates who were subsequently enrolled in the study was 13.5% for CSV recruitment and 21% for CB recruitment. Ascertainment and screening costs combined were $158 per CB recruit compared to $232 per CSV recruit. Using multiple recruitment approaches we successfully achieved our enrollment goal of at least 100 volunteers from diverse populations by the end of the planned recruitment period.

[Instrumental, directive, and affective communication in hospital leaflets]. / Comunicação instrumental, diretiva e afetiva em impressos hospitalares.

This study focuses on the typical semantic systems extracted from hospital staff communicative resources which attempt to validate information as an "object" to be transferred to patients. We describe the models of textual communication in 58 patient information leaflets from five hospital units in Brazil, gathered from 1996 to 2002. Three categories were identified, based on the theory of speech acts (Austin, Searle, and Habermas): 1) cognitive-instrumental utterances: descriptions by means of technical terms validated by self-referred, incomplete, or inaccessible argumentation, with an implicit educational function; 2) technical-directive utterances: self-referred (to the context of the source domains), with a shifting of everyday acts to a technical terrain with a disciplinary function and impersonal features; and 3) expressive modulations: need for inter-subjective connections to strengthen bonds of trust and a tendency to use childish arguments. We conclude that the three categories displayed: fragmentary sources; assumption of univocal messages and invariable use of information (idealized motivations and interests, apart from individualized perspectives); and assumption of universal interests as generators of knowledge.

[Hospital leaflets and the dynamics of constructing their meanings: the perspective of health professionals]. / Impressos hospitalares e a dinâmica de construção de seus sentidos: o ponto de vista dos profissionais de saúde.

Based on interviews in a hospital in Rio de Janeiro, the authors analyze strategies, interests, assumptions, and concerns among producers of patient information leaflets on infectious diseases. Most such publications followed a linear communications model, according to which health messages produce a sole and single effect on their audience. Visual communications are seen as a field of knowledge over which physicians have no "command", but which raises great expectations on their part, principally in light of the limits of written language for an illiterate patient population. The most frequent concerns relate to the "adequacy of the language" (a denotative, non-semantic function of language) and on the increase in "dissemination". Leaflets are generally linked to the professional experience of providing health care, but the lack of pertinent research prior to the production of such publications leads to simplifications and generalizations concerning the patients' most common doubts and questions, reinforcing the stereotyping of the clientele based on their lacks and needs. In two exceptional leaflets, interaction with the clientele appears and expands the relationship between the health care professionals and the values and decisions made in distinct sociocultural contexts.