O cidadão usuário do serviço odontológico do Sistema Único de Saúde sabe onde reclamar? O controle social na saúde / The user of dental service in Unified Health System knows where to complain? Social control in health

Objetivo ­ Verificar o conhecimento de usuários do serviço odontológico do SUS sobre o sistema de ouvidoria e a sua capacidade resolutiva e como objetivo secundário relacionar a satisfação do usuário com a resolubilidade do serviço. Um dos eixos norteadores do Sistema Único de Saúde (SUS) é o controle social, que garante a participação dos cidadãos na gestão da saúde. As ouvidorias públicas de saúde são um importante instrumento para auxiliar a administração pública. Método ­ Trata-se de uma pesquisa transversal, tipo inquérito, cuja população de estudo foi composta por 461 usuários do serviço odontológico do SUS. Realizou-se entrevista com questionário estruturado. Resultados ­ Houve predomínio de usuários do gênero feminino (70,5%), solteiros (57,0%), com renda de 1 a 2 salários mínimos (49,2%) e ensino médio incompleto (39,3%). O principal motivo para a procura ao serviço de 50,8% dos entrevistados foi a busca por tratamento. Quanto ao sistema de ouvidorias, 76,4% não sabiam onde reclamar; 4,8% fizeram algum tipo de reclamação ou sugestão, e 43% deles tiveram algum retorno. Do total de entrevistados, 73,3% afirmaram terem todos os seus problemas de saúde bucal resolvidos na Unidade de Saúde e 72,6% estavam satisfeitos. A satisfação esteve associada com a percepção sobre a resolubilidade do serviço (p< 0,0001). Conclusões ­ Os usuários do SUS não sabem onde podem reclamar, entretanto, estão satisfeitos com o serviço e com a resolutividade de seus problemas bucais pela equipe de saúde bucal.

Objective ­ Check the knowledge of users SUS dental service on the ombudsman system and its response capacity and as a secondary objective relate to user satisfaction with the resolution of the service. One of the principles of the Unified Health System (SUS) is social control, which guarantees user participation in health management. Health public ombudsmen are an important instrument to help the public administration. Method ­ It is a cross-sectional survey, survey type, whose study population consisted of 461 users of the SUS dental service. An interview was conducted with structured questionnaire. Results ­ Users predominance was female (70.5%), single (57.0%), earning 1-2 minimum salary (49.2%) and incomplete secondary education (39.3%). The main reason for seeking to 50.8% of respondents service was seeking treatment. As the ombudsman system, 76.4% did not know where to complain; 4.8% had some type of complaint or suggestion, and 43% of them had some return. Of the total respondents, 73.3% said they had all their oral health problems resolved at the Health Unit and 72.6% were satisfied. The satisfaction was associated with the perception of the solvability of service (p< 0.0001). Conclusion ­ SUS users do not know where they can complain, however, are satisfied with the service and the resoluteness of their oral problems for the oral health team.

Assessment of health-related quality of life and related factors in patients with chronic liver disease

ABSTRACT BACKGROUND AND OBJECTIVES: Assessing health-related quality of life is an important aspect of clinical practice. Thus, the present study attempts to assess the health-related quality of life of patients with chronic liver disease. METHODS: A cross-sectional survey was conducted on 133 chronic liver disease patients, using three instruments: a demographic questionnaire, the Chronic Liver Disease Questionnaire, and Model for End-Stage Liver Disease index. Variables were expressed as frequencies, percentages, means, and standard deviations. The statistical analysis included Pearson's correlation, Student's t-test, and analysis of variance (p < 0.05 was considered significant). RESULTS: The mean age of included subjects was 50.5 ± 13.3 years. The majority were male (66.2%), Caucasian (70.7%), and had a family income of US$329-US$658.2. Over half of the patients (56.4%) were infected by hepatitis C virus and 93.2% had low Model for End-Stage Liver Disease scores. Model for End-Stage Liver Disease score was related to age (r = 0.185;p = 0.033). Higher mean Chronic Liver Disease Questionnaire scores were obtained for emotional function (39.70/SD ± 12.98) and while lower scores were obtained for abdominal symptoms (16.00/SD ± 6.25). Fifty-two patients (39.1%) presented overall low (<5) Chronic Liver Disease Questionnaire scores. Furthermore, Chronic Liver Disease Questionnaire score was related to family income (r = 0.187, p = 0.031). CONCLUSION: Most individuals presented high mean Chronic Liver Disease Questionnaire scores, indicating low health-related quality of life, especially individuals with low family income.

Elderly caregivers at long-stay institutions: quality of life and temporomandibular dysfunction

Abstract Aim: To assess the profile, quality of life and the presence of Temporomandibular Disorders (TMD) in elderly caregivers. Methods: Thirty-nine caregivers who worked in six long-stay institutions for the elderly in three different municipalities participated in the study. The research instruments were the WHOQOL-BREF, the Fonseca questionnaire and the socio-demographic questionnaire. The Kruskal-Wallis test with the Dunn's correction was performed at a level of 5%. Results: Females accounted for 94.9% of the sample. The average monthly wage was R$ 832.00. The average working week was 39 hours. The WHOQOL dominions showed the following averages: 74.25 Physical; 70.33 Psychological; 65.79 Social Affairs; 58.38 Environment. Mild DTM was present in 43.6% of the caregivers, of which 7.7% were moderate, 5.2% severe, 23.0% of the professionals were asymptomatic and 20.5% did not answer. The association between TMD and the quality of life showed p=0.6752. Conclusions: It was concluded that there was no relationship between the quality of life and symptoms of temporomandibular dysfunction among the caregivers of elderly in this study.

Quality of life of people living with HIV/AIDS treated by the specialized service in Vitória-ES, Brazil / Qualidade de vida de pessoas que vivem com HIV/AIDS assistidas no serviço especializado em Vitória (ES), Brasil

The aim of this study is to establish the factors that influence the quality of life of people living with HIV/AIDS being treated at a specialized public service. The participants answered the questionnaire on sociodemographic conditions, issues related to HIV and daily habits. The quality of life was analyzed using the HIV/AIDS-targeted quality of life (HAT-QoL) instrument with 42 items divided into 9 fields: General Activity, Sexual Activity, Confidentiality Concerns, Health Concerns, Financial Concerns, HIV Awareness, Satisfaction with Life, Issues related to Medication and Trust in the Physician. Bivariate and multiple linear regressions were performed. Of the participants, 53.1% were women and had a mean age of 42 years. In analyzing the quality of life, the HAT-QoL domain with the lowest average was Financial Concerns (39.4), followed by Confidentiality Concerns (43.2), Sexual Activity (55.2) and Health Concerns (62. 88). There was an association between the variables: not being gainfully employed (p < 0.001), being mulatto or black (p = 0.045) and alcohol consumption (p = 0.041) with the worst quality of life scores. Inadequate socioeconomic and health conditions had a negative impact on the quality of life of people with HIV/AIDS.

O objetivo do presente estudo é verificar os fatores que influenciam na qualidade de vida das pessoas que vivem com HIV/AIDS assistidas no serviço especializado. Os entrevistados responderam os questionários sobre condições sociodemográficas, aspectos relacionados ao HIV e hábitos. A qualidade de vida foi analisada por meio do instrumento HAT-QoL, com 42 itens divididos em nove domínios: Atividade Geral, Atividade Sexual, Preocupações com Sigilo, Preocupação com a Saúde, Preocupação Financeira, Conscientização sobre o HIV, Satisfação com a Vida, Questões relativas à medicação e Confiança no médico. Análises bivariadas e regressão linear múltipla foram realizadas. Dos entrevistados, 53,1% eram mulheres e tinham média de idade de 42 anos. Na análise da qualidade de vida, o domínio do HAT-QoL com menor média foi Preocupação financeira (39,4), seguido de Preocupação com sigilo (43,2), Atividades sexuais (55,2) e Preocupação com a saúde (62,88). Houve associação entre as variáveis não ter vínculo trabalhista (p < 0,001), ser pardo ou negro (p = 0,045) e consumir bebida alcoólica (p = 0,041), com piores escores da qualidade de vida. Condições socioeconômicas e de saúde inadequadas apresentaram impacto negativo na qualidade de vida das pessoas com HIV/AIDS.

The stigma and prejudice of leprosy: influence on the human condition

INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation. .

O conceito de saúde geral e bucal na visão dos cuidadores de idosos / The meaning of general and oral health on the elderly caregiver's view

A pesquisa objetivou analisar a percepção dos cuidadores de idosos em relação aos conceitos de saúde bucal e geral e em relação ao estado de saúde dos idosos institucionalizados. Realizou-se uma pesquisa qualitativa pela técnica do Discurso do Sujeito Coletivo. Foram entrevistados 42 cuidadores de idosos das instituições asilares de Araçatuba, SP e Passo Fundo, RS por meio de um questionário estruturado, pré-testado em um estudo piloto. As entrevistas foram gravadas e transcritas para a análise qualitativa. Foram elaborados com base nas respostas sete Discursos do Sujeito Coletivo (DSCs). A saúde bucal, segundo os cuidadores, consiste nos hábitos de higienização e na boa alimentação, enquanto a ausência é compreendida pelas sequelas das patologias bucais. Os antigos conceitos de saúde estão sendo substituídos pelas novas percepções de qualidade de vida, porém eles ainda são divergentes entre profissionais mais antigos e os formados nas últimas duas décadas. Essa percepção de saúde como qualidade de vida ainda não chegou à odontologia, em que permanece o antigo conceito da ausência de sintomas. Para uma parcela dos cuidadores, os idosos institucionalizados não possuem saúde bucal, e a única forma de melhorar sua condição é por meio do atendimento clínico.

The aim of this study was to analyze the perception of elderly caregivers in relation to the meaning of general and oral health and about oral health status of the institutionalized aged. It was performed a qualitative study, using Discourse of Collective Subject method. It were interviewed 42 caregivers who worked in longterm care facilities of Araçatuba City, SP and Passo Fundo City, RS - Brazil, applying a structured questionnaire. The interviews were recorded and transcript to be performed the qualitative analysis. The answers were analyzed and them it was elaborated the discourses of collective subject (DCS). Oral health, according to caregivers, was hygiene habits and good diet, while the absence of oral health was sequelae of oral diseases. It's possible to note that older means of health were being substituted by new perceptions of quality of life and is very divergent between older professionals and those who graduated during last two decades. However, according to caregivers, this health perception as quality of life was not included in Dentistry, where the old mean "absence of symptoms" was prevalent. For part of them, the institutionalized elderly have no oral health and the only way to improve their condition was through clinical attendance.