Health actions and occupational vocal conservation: how are they being implemented?

The actions in Occupational Speech Therapy are becoming more evident with the emergence of new experiences and interventions that aim to intercept the disease process, emphasizing the prevention and protection of vocal health in the occupational context. This work aims to analyze how health and occupational vocal conservation actions are being implemented. This is an integrative literature review, whose survey was carried out from June to October 2020, in the Capes Periódicos platform, using the descriptors "worker's health" and voice. After applying the defined exclusion and inclusion criteria and subtraction of repeated publications, a total of 16 articles were selected. The teacher's voice has been a priority object in Brazilian speech therapy research in recent years. The results presented show the importance of health promotion actions that aim at the well-being of workers as a whole, in an integral and multidisciplinary way. Occupational vocal health and conservation actions encompass activities related to vocal health surveillance and risk conditions for the development of voice disorders, vocal health education, direct vocal interventions, voice assessment, laryngological assessment, referrals and assessment of workers' perception of the proposed actions.

As ações em Fonoaudiologia do Trabalho vêm se tornando mais evidentes com o surgimento de novas experiências e intervenções que visam interceptar o processo da doença, enfatizando a prevenção e a proteção da saúde vocal no contexto ocupacional. Este trabalho visa analisar como estão sendo implementadas as ações de saúde e conservação vocal ocupacional. Tratou-se de uma revisão bibliográfica integrativa, cujo levantamento foi realizado no período de junho a outubro de 2020 na plataforma Periódicos CAPES, utilizando-se os descritores "saúde do trabalhador" e "voz". Após a aplicação dos critérios de exclusão e inclusão definidos e subtração das publicações repetidas, foi selecionado um total de 16 artigos. A voz de professores vem sendo objeto priorizado nas pesquisas fonoaudiológicas brasileiras nos últimos anos. Os resultados apresentados elencam a importância de ações de promoção da saúde, que objetivem o bem-estar dos trabalhadores como um todo, de forma integral e multidisciplinar. As ações de saúde e conservação vocal ocupacional englobam atividades relacionadas à vigilância da saúde vocal e de condições de risco para o desenvolvimento dos distúrbios de voz, à educação em saúde vocal, a intervenções vocais diretas, à avaliação da voz e laringológica, a encaminhamentos e à avaliação da percepção dos trabalhadores diante das ações propostas.

Anxiety, Depression, and Other Factors Associated With Voice Handicaps in Active Older People During the COVID-19 Pandemic.

During the COVID-19 pandemic, older people had to remain isolated, which could cause not only anxiety and depression but also voice and communication problems and lifestyle, demographic, and socioeconomic changes. This study aimed to analyze the influence of anxiety and depression and other associated factors on the voice handicap of active older adults during the COVID-19 pandemic. This cross-sectional and analytical research approached older people enrolled at a reference health care unit for this age group in Recife. Demographic, socioeconomic, and lifestyle data were surveyed with interviews. Mental health measures were obtained with the Self-Reporting Questionnaire, State-Trait Anxiety Inventory, and Geriatric Depression Scale. Voice handicap was assessed with the Voice Handicap Index. Analyses were performed with descriptive and inferential statistics. The study compared older people with lesser and greater voice handicaps, using the chi-square and Wald tests. The association was assessed according to the binary and multivariate logistic regression model. Altogether, 91 older people with a mean age of 69 years participated in the research, most of whom (54.9%) did not have voice handicaps. Trait anxiety (P = 0.031) and age (P = 0.036) were associated with voice handicaps. Active older adults with higher trait anxiety were five times as likely to have voice handicaps (odds ratio = 5.151) as those with low trait anxiety. Moreover, the ones with more advanced age were 10% more likely to have voice handicaps (odds ratio = 1.100) than younger participants. It is concluded that, during the pandemic, voice handicap in active older people was associated with trait anxiety and age.

Building the mental health care network for children and adolescents: interventions in the territory.

Children with mental disorders may develop serious adverse effects in their functional performance. A structured care network may favor psychosocial components, such as self-confidence and problem solving capacity. This work seeks to identify the care network for children with mental disorders and develop interventions in the territory, highlighting changes achieved from these actions. This is a descriptive study based on the action research methood using an eco-Map for data presentation. The results indicate that the majority of children have stressful relationships within the family, and relationships of greater intensity and quality with the Community Health Workers, Primary Care and Education, with childcare, compared with specialist health services. The interventions were based on the guidelines of Family Health, Support Center and stressed the strengthening of family ties, and liaison with health services and schools/ daycare centers.

[Rehabilitation care for victims of accidents and violence: the situation of the municipal districts in Pernambuco, Brazil]. / Assistência em reabilitação para vítimas de acidentes e violência: a situação dos municípios em Pernambuco, Brasil.

A diagnostic analysis of care was conducted for rehabilitation of victims of accidents and violence in municipal districts of Pernambuco, Brazil, with over 100 thousand inhabitants. A cross-sectional and descriptive study was carried out. The principles of the triangulation method were followed because the study required the input of various informers and used a variety of collection techniques. An interview was conducted with the municipal manager of each district to map out and select the services to be analyzed. Questionnaires were applied to the managers of the services for identification of the unit, characterization of the activities and description of the structure. The results revealed that more than half of the services involved group care, prevention of relapses and neuropsychomotor stimulation. The team numbered 273 health professionals, with physiotherapists being the largest group (34.8%), followed by psychologists (13.5%), and speech therapists (12.8%). Only one municipal district supplied ortheses, prostheses and auxiliary equipment for locomotion. Deficits of some types of services and discrepancies in the distribution of such services were observed in the different areas of the state.

[Health care for aged victims of accidents and violence: analysis of SUS health services in Recife (PE, Brazil)]. / Assistência à saúde dos idosos vítimas de acidentes e violência: uma análise da rede de serviços SUS no Recife (PE, Brasil).

A situational diagnosis of the health services regarding the care of aged victims of accidents and violence (AVAV) was carried out in Recife, Pernambuco, Brazil. The National Policy for Reducing Accident and Violence Related Morbidity and Mortality and the National Policy for the Aged People Health were used as references. The methodology was based on the triangulation method, with both quantitative and qualitative approaches. Questionnaires and interviews were answered by managers and health staff of hospital, prehospital and rehabilitation services; and local aged health policy managers. In 2006, only the Family Health Program reported prehospital care for AVAV, 31 cases were due to violence and 18 to accidents. The hospital care for aged people was 7.2% of the total care, 27% from accidents and 10% from violence. In the same year, there was no record of rehabilitation care of AVAV. The directives of the policies studied are only partially followed. The health care is deficient in several aspects, such as: clinical protocols; notification devices; support to the aged, caregivers and aggressors; and also continuous training. This analysis can be such a contribution to the reorganization of the local health system, recognizing the aged person as vulnerable to accidents and violence.

[Diagnostic analysis of the rehabilitation services that attend victims of accidents and violence in Recife]. / Análise diagnóstica dos serviços de reabilitação que assistem vítimas de acidentes e violências em Recife.

This paper aims to analyze the rehabilitation services in Recife, Brazil, confronting it with what the National Policy for Decreasing Morbimortality from Accidents and Violence (NPDMAV) professes. Six units of rehabilitation services were analyzed; five were from municipal administration and the other was an ONG on an agreement with SUS. A partial structured interview was conducted with the person in charge for the Attention to the Disable Person's Health aiming to map the network. Also a questionnaire was applied to the managers of the six services aiming to identify the unit and its activities, structure and organization. The Rehabilitation Assistance network in Recife do not meet the NPDMAV guidelines as it presents: decreased number of services/programs; lack of a multidisciplinary team; lack of technological support; deficient joint intra and inter sectors; little interaction between the victim and his family to reinsertion into family and social life; and still incipient prevention and promotion actions. In conclusion, there is an effort to adequate the actions to this population group; however there are relevant covering deficits of people, equipments, information and articulation registers among the various levels of this health network.