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BACKGROUND: Population aging is forcing the transformation of health care. Long-term care in the home is complex and involves complex communication with primary care services. In this scenario, the expansion of digital health has the potential to improve access to home-based primary care; however, the use of technologies can increase inequalities in access to health for an important part of the population. The aim of this study was to identify and map the uses and types of digital health interventions and their impacts on the quality of home-based primary care for older adults. METHODS: This is a broad and systematized scoping review with rigorous synthesis of knowledge directed by the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The quantitative data were analyzed through descriptive statistics, and the qualitative data were analyzed through basic qualitative content analysis, considering the organizational, relational, interpersonal and technical dimensions of care. The preliminary results were subjected to consultation with stakeholders to identify strengths and limitations, as well as potential forms of socialization. RESULTS: The mapping showed the distribution of publications in 18 countries and in the Sub-Saharan Africa region. Older adults have benefited from the use of different digital health strategies; however, this review also addresses limitations and challenges, such as the need for digital literacy and technological infrastructure. In addition to the impacts of technologies on the quality of health care. CONCLUSIONS: The review gathered priority themes for the equitable implementation of digital health, such as access to home caregivers and digital tools, importance of digital literacy and involvement of patients and their caregivers in health decisions and design of technologies, which must be prioritized to overcome limitations and challenges, focusing on improving quality of life, shorter hospitalization time and autonomy of older adults.
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Serviços de Assistência Domiciliar , Atenção Primária à Saúde , Humanos , Atenção Primária à Saúde/normas , Idoso , Serviços de Assistência Domiciliar/normas , Telemedicina/normas , Qualidade da Assistência à Saúde/normasRESUMO
Introduction: Using digital health in primary health care (PHC) contributes to reducing costs and travel time, achieving global development goals, improving access, quality and longitudinality of care, and managing health crises. Its evaluation must go beyond the technical-operational aspects to include patient satisfaction, a key element in assessing the quality of care. Objective: To identify and map patient satisfaction (expectations, desires, cultural values) about the adoption of digital health strategies and assess their impact on the quality of care in PHC. Methods: The review will follow the recommendations proposed by the Joanna's Briggs Institute (JBI) manual, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the methodology proposed by Arksey and O'Malley and Levac et al. and will be conducted in nine stages. The search will be conducted in health studies databases (MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, and BVS), gray literature, and preprint repositories (Google Scholar and MedRxiv). Two reviewers will select the studies, and the third will analyze possible conflicts. The inclusion criteria comprise studies that have been made available in their entirety, whether they are primary studies or short communications, as well as the following materials extracted from the gray literature: preprints, manuals, government documents, books, guidelines, theses and dissertations. Exclusion criteria include literature reviews, abstracts, books, conference archives, letters to the editor, duplicates and opinion articles. Data will be analyzed by content analysis and inferential statistics. This protocol is registered on the Open Science Framework (OSF) under DOI 10.17605/OSF.IO/PUJDB. Results: The study aims to understand aspects related to the expectations, desires, and cultural values of patients from different countries, as well as the strengths and critical nodes of the use of digital health on the quality of care in PHC.
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Satisfação do Paciente , Atenção Primária à Saúde , Humanos , Telemedicina , Qualidade da Assistência à Saúde , Projetos de Pesquisa , Saúde DigitalRESUMO
Digital health and sustainable development goals have had strong impacts with the COVID-19 pandemic. In Brazil, the health crisis scenario required changes in social welfare programs and policies, based on recommendations from international agencies, such as the UN and WHO. This study aims to analyze the alignment of the arguments of Brazilian and international organizations for the adoption of digital health in Primary Health Care based on the COVID-19 pandemic. This is a qualitative documentary study of the rhetorical analysis type, based on Perelman and Obrechts-Tyteca's Theory of Argumentation. The search for documents was carried out by two independent researchers, between December 2021 and June 2022, through the websites of the World Health Organization, the Pan American Health Organization, the Brazilian Ministry of Health, and the Federal Councils of Medicine and Brazilian nursing, with the terms "digital health," "telehealth," "telemedicine," "e-health," "telehealth," "telenursing," "telemedicine," and "digital health." Twenty official documents were analyzed and identified in terms of context, authorship, authenticity, reliability, nature, and key concepts. The international and Brazilian arguments emphasize the applicability of Information and Communication Technologies (ICTs) in the health field. In logical arguments, based on the structure of reality, international agencies emphasize the overlap between health needs and the conditions for the applicability of ICTs. In Brazil, however, there was a need to regulate the digital practices of health professionals. In the international discourse, in the structuring of reality, there are illustrations of the relationship between the context of the health crisis caused by COVID-19 and the concrete conditions for the applicability of digital health; while in the Brazilian discourse, the need to strengthen an environment conducive to digital health is explicit. The Brazilian alignment in relation to the international premises is evident. Yet, there is a need, socially and economically sustainable, to strengthen the inclusion of digital health in PHC policy.
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BACKGROUND: Latin America, Africa, and Asia have high incidences of syphilis. New approaches are needed to understand and reduce disease transmissibility. In health care, spatial analysis is important to map diseases and understand their epidemiologic aspects. OBJECTIVE: The proposed scoping review will identify and map the use of spatial analysis as a tool for syphilis-related research in health care. METHODS: This protocol was based on the Joanna Briggs Institute manual, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We will conduct searches in Embase; Lilacs, via the Virtual Health Library (Biblioteca Virtual en Salud; BVS), in Portuguese and English; Medline/PubMed; Web of Science; Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. Gray literature will be searched for in Google Scholar, the Digital Library of Theses and Dissertations, the Catalog of Theses and Dissertations of the Coordination of Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; CAPES), Open Access Theses and Dissertations, ProQuest Dissertations and Theses Global, and the Networked Digital Library of Theses and Dissertations. The main research question is "How has spatial analysis been used in syphilis-related research in health care?" Studies are included if they have the full text available, address syphilis, and use geographic information systems software and spatial analysis techniques, regardless of sample characteristics or size. Studies published as research articles, theses, dissertations, and government documents will also be considered, with no location, time, or language restrictions. Data will be extracted using a spreadsheet adapted from the Joanna Briggs Institute. Quantitative and qualitative data will be analyzed using descriptive statistics and a thematic analysis, respectively. RESULTS: The results will be presented according to the PRISMA-ScR guidelines and will summarize the use of spatial analysis in syphilis-related research in health care in countries with different contexts, factors associated with spatial cluster formation, population health impacts, contributions to health systems, challenges, limitations, and possible research gaps. The results will guide future research and may be useful for health and safety professionals, managers, public policy makers, the general population, the academic community, and health professionals who work directly with people with syphilis. Data collection is projected to start in June 2023 and end in July 2023. Data analysis is scheduled to take place in August and September 2023. We expect to publish results in the final months of 2023. CONCLUSIONS: The review may reveal where syphilis incidence has the highest incidence, which countries most use spatial analysis to study syphilis, and whether spatial analysis is applicable to syphilis in each continent, thereby contributing to discussion and knowledge dissemination on the use of spatial analysis as a tool for syphilis-related research in health care. TRIAL REGISTRATION: Open Science Framework CNVXE; https://osf.io/cnvxe. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43243.
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BACKGROUND: Work can be considered a source of living, well-being, and socioeconomic development. When the work environment negatively influences individuals, it may trigger emotional disturbances, behavioral problems, chronic stress conditions, and illnesses such as burnout syndrome (BS). Recently, studies on BS have increased and placed a special focus on health care professionals. The prevalence of BS among health professionals is associated with their chronic exposure to human hardship and long working hours without proper rest. These factors have contributed to greater stress and high physical and emotional exhaustion levels. OBJECTIVE: This study aims to identify and map studies using the Maslach Burnout Inventory (MBI) scale to identify burnout syndrome in health professionals working in public health services. METHODS: This scoping review was developed based on the Joanna Briggs Institute (JBI) Reviewers Manual and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A total of 6 databases were searched to identify relevant studies: Embase, LILACS, MEDLINE or PubMed, PsycInfo, Scopus, and Web of Science. Gray literature was consulted on ProQuest Dissertations and Theses Global, Google Scholar, Brazilian Digital Library of Theses and Dissertations, and Open Access Theses and Dissertations. Additionally, the reference lists were searched to retrieve studies not previously selected. The steps followed in this study were proposed by Arskey and O'Malley and Levac, Colquhoun, and O'Brien: identification of research questions, identification of potential studies, study selection, data extraction and imputation, data analyses and interpretation, and consultation with stakeholders. The detailed methodology was published in a protocol. RESULTS: A total of 55 articles were identified after screening for eligibility criteria, published between 1999 and 2021 in 32 countries. Most reports were published in Brazil, Spain, and China. A total of 22 versions of the MBI were identified, presenting different items, scores, and cutoff points. The included studies had recommendations and implications for clinical practice. The consultation with stakeholders allowed knowledge translation for those interested in BS. CONCLUSIONS: Studies mostly included physicians (34/55, 61.8%) and nurses (24/55, 43.6%), and the original version of MBI was predominantly used. Divergences in BS classification were highlighted, which may be related to MBI cross-cultural adaptations and applications in other countries. This study contributes to the advancement of research regarding burnout syndrome as an occupational illness since it has harmful consequences for workers, health care services, and the quality of care provided to the population.
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Introduction: The use of digital health interventions has expanded, particularly in home-based primary care (HBPC), following the increase in the older adult population and the need to respond to the higher demand of chronic conditions, weakness and loss of autonomy of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this risk group. The objective of this study is to map and identify the uses and types of digital health interventions and their reported impacts on the quality of HBPC for older adults worldwide. Methods and analysis: This is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed from the theoretical perspective of Arksey and O'malley, with updates by Levac and Peters and respective collaborators based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from white literature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, MEDLINE/PubMed, Scopus, Web of Science, Cinahl and Embase; while Google Scholar will be used for gray literature. No date limit or language restrictions will be determined. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of the study and will later be disseminated through publication in open access scientific journals, scientific events and academic and community journals. The full scoping review report will present the main impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in primary home care. Discussion: The organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of scoping reviews, reducing the risk of bias.
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COVID-19 , Humanos , Idoso , COVID-19/epidemiologia , Confiabilidade dos Dados , Bases de Dados Factuais , Tecnologia Digital , Atenção Primária à Saúde , Revisões Sistemáticas como Assunto , Literatura de Revisão como AssuntoRESUMO
This study identified and mapped worldwide surveillance actions and initiatives of drinking water quality implemented by government agencies and public health services. The scoping review was conducted between July 2021 and August 2022 based on the Joanna Briggs Institute method. The search was performed in relevant databases and gray literature; 49 studies were retrieved. Quantitative variables were presented as absolute and relative frequencies, while qualitative variables were analyzed using the IRaMuTeQ software. The actions developed worldwide and their impacts and results generated four thematic classes: (1) assessment of coverage, accessibility, quantity, and drinking water quality in routine and emergency situations; (2) analysis of physical-chemical and microbiological parameters in public supply networks or alternative water supply solutions; (3) identification of household water contamination, communication, and education with the community; (4) and investigation of water-borne disease outbreaks. Preliminary results were shared with stakeholders to favor knowledge dissemination.
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Água Potável , Qualidade da Água , Abastecimento de Água , Poluição da Água , Surtos de DoençasRESUMO
BACKGROUND: Burnout syndrome is a chronic response to stressors in the workplace. It is characterized by emotional exhaustion and physical and mental burnout and may lead to high employee turnover, work absenteeism, and increased occupational accidents. Most studies use the Maslach Burnout Inventory (MBI) to identify burnout and implement preventive actions and treatments. OBJECTIVE: This study presents a scoping review protocol to identify and map studies that used MBI to assess burnout syndrome in health care professionals working in public health services. METHODS: This scoping review protocol follows the Joanna Briggs Institute reviewers' manual, and this protocol consists of 6 stages: identifying the research question, identifying relevant studies, study selection, data extraction and coding, analysis and interpretation of results, and consultation with stakeholders. We will conduct searches in Embase, LILACS, PubMed/MEDLINE, PsycINFO, Scopus, Web of Science databases, and gray literature. The main research question is as follows: how is MBI used to identify burnout syndrome in health care professionals working in public health services? Inclusion criteria will comprise qualitative and quantitative studies using MBI to identify burnout syndrome in health care professionals working in public health services and no restrictions in language and publication dates. Data will be extracted using a spreadsheet adapted from the Joanna Briggs Institute model. Quantitative and qualitative data will be analyzed using descriptive statistics and thematic analysis, respectively. The consultation with stakeholders will be essential for increasing the knowledge about MBI, identifying new evidence, and developing future strategies to guide public policies preventing burnout syndrome in health care professionals working in public services. RESULTS: This protocol will guide a scoping review to identify and map studies that used MBI to identify burnout syndrome in health care professionals working in public health services. The results of this review may be useful to public health care professionals, managers, policymakers, and the general population because these findings will help understand the validated, translated, and adapted versions of MBI and domains, number of items, Likert scales, and cutoff points or the latent profile analysis most used in the literature. Furthermore, possible research gaps may be identified to guide future studies. All information regarding the stages of the scoping review favor its transparency and allow it to be methodologically replicated according to the principles of open science, thereby reducing the risk of bias and data duplication. CONCLUSIONS: This study may reveal the multiplicity of scales described in the literature and the different forms of assessing burnout syndrome in health care professionals. This study may help to standardize the assessment of burnout syndrome in health care professionals working in public health services and contribute to the discussion and knowledge dissemination about burnout syndrome and mental health in this population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42338.
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Universal access to clean and safe drinking water is essential for life maintenance since exposure to poor quality water is harmful to health. Drinking water quality is part of public health actions and, together with sanitation, a human right essential for life and a sustainable development goal. Moreover, an independent surveillance system conducted by the Ministry of Health or government agencies is needed for the safety of drinking water quality. We propose a scoping review protocol to identify and map worldwide surveillance actions and initiatives of drinking water quality implemented by government agencies or public health services. This scoping review protocol is based on the Joanna Briggs Institute manual and guided by the PRISMA-ScR. Articles, theses, dissertations, and official documents consulted in the following databases will be included: Medline/PubMed, Scopus, LILACS, Web of Science, Embase, Engineering Village, and gray literature. No date limit or language will be determined. The authors will develop a worksheet for data extraction. Quantitative (simple descriptive statistics) and qualitative data (thematic analysis) will be analyzed. The final scoping review will present the main findings, impacts, challenges, limitations, and possible research gaps related to surveillance of drinking water quality on population health.
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Água Potável , Humanos , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto , Qualidade da ÁguaRESUMO
BACKGROUND: The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. OBJECTIVE: The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. METHODS: We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. RESULTS: A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. CONCLUSIONS: The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.
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INTRODUCTION: Telemedicine gained strength in primary healthcare (PHC) during the COVID-19 pandemic. Thus, there is a need to know its scope, technologies used and impacts on people's health. This study will map telemedicine use in PHC around the world and its impacts on quality of care in the context of the COVID-19 pandemic. METHODS: This is a scoping review protocol developed according to Arksey and O'Malley and Levac et al, based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The records will be mapped in the following multidisciplinary health sciences databases: Virtual Health Library, PubMed, Scopus, Web of Science, CINAHL and Embase. Searches will also be conducted on Google Scholar, preprint repositories and specific COVID-19 databases (grey literature). Quantitative data will be analysed using descriptive statistics, while thematic analysis will be performed for qualitative data. Preliminary findings will be presented to stakeholders to identify missing studies and develop effective dissemination strategies. ETHICS AND DISSEMINATION: Results will be disseminated through publication in an open access scientific journal, scientific events, and academic and community newspapers. Ethical approval was obtained due to stakeholder consultation, but will not involve the direct participation of patients. Link to the protocol record in the Open Science Framework (OSF) (osf.io/q94en).
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COVID-19 , Telemedicina , Humanos , Pandemias , Atenção Primária à Saúde , Qualidade da Assistência à Saúde , Projetos de Pesquisa , Literatura de Revisão como Assunto , SARS-CoV-2 , Revisões Sistemáticas como AssuntoRESUMO
Objetivo: analisar o conceito do "cuidado centrado no paciente" à luz do método evolucionário de Rodgers. Método: trata-se de uma análise conceitual referenciada pelo Método Evolucionário de Rodgers acerca do conceito "cuidado centrado no paciente". Os dados quantitativos foram analisados com estatística descritiva simples e os qualitativos, pela análise similitude, com o apoio do software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRaMuTeQ). Resultados: a percepção dos autores sobre o conceito em análise retrata o paciente como elemento basilar da discussão e apontam como vocábulos que tangenciam essa centralidade: saúde, cuidado, necessidade, processo. Conclusão: revelou-se a heterogeneidade de termos substitutos empregados para o termo em estudo e por conseguinte a ausência de padronização conceitual
Objective: to analyze the concept of "patient-centered care" in the light of Rodgers' evolutionary method. Method: this is a conceptual analysis referenced by Rodgers' Evolutionary Method about the concept "patient-centered care". Quantitative data were analyzed using simple descriptive statistics and qualitative data using similarity analysis, with the support of the software Interface de R pour les Analyzes Multidimensionnelles by Textes et de Questionnaires (IRaMuTeQ). Results: the authors' perception of the concept under analysis portrays the patient as a basic element of the discussion and points out as words that touch upon this centrality: health, care, need, process. Conclusion: the heterogeneity of substitute terms used for the term under study was revealed and, consequently, the absence of conceptual standardization. Descriptors: Patient-Centered Care; Concept Formation; Quality of Care and Patient Safety
Objetivo: analizar el concepto de "atención centrada en el paciente" a la luz del método evolutivo de Rodgers. Método: se trata de un análisis conceptual referenciado por el Método Evolutivo de Rodgers sobre el concepto de "atención centrada en el paciente". Los datos cuantitativos se analizaron mediante estadística descriptiva simple y los datos cualitativos mediante análisis de similitud, con el apoyo del software Interface de R pour les Analyzes Multidimensionalelles de Textes et de Questionnaires (IRaMuTeQ). Resultados: la percepción de los autores sobre el concepto analizado retrata al paciente como elemento básico de la discusión y apunta como palabras que tocan esta centralidad: salud, cuidado, necesidad, proceso. Conclusión: se puso de manifiesto la heterogeneidad de los términos sustitutos utilizados para el término en estudio y, en consecuencia, la ausencia de estandarización conceptual
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Humanos , Masculino , Feminino , Padrões de Referência , Assistência Centrada no Paciente , Segurança do Paciente , Qualidade da Assistência à SaúdeRESUMO
Abstract The objective was to identify the actions developed by the health systems of Brazil and Italy to face the pandemic caused by COVID19. This is an integrative literature review in the Web of Science, Scopus, Pubmed and Virtual Health Library databases, with the addition of the snowball technique, in July 2020. After collection, 48 publications constituted the sample. The actions of the health systems of the two countries to face the pandemic were grouped into the categories: Adequacy of the legal norms of the health system; Expansion and strengthening of the health system; Use of Information and Communication Technologies; Encouraging individual and collective measures to face the pandemic; and Limitations and challenges in facing the pandemic. The measures adopted are influenced by the political, economic and social contexts. There was a reorganization of the hospital network in both countries, but weaknesses are identified in the preventive actions developed by Primary Health Care, with a predominance of the biomedical model. Telemedicine stood out in this scenario and could last in the post-pandemic. The summary of actions will subsidize the confrontation of other pandemics that, eventually, the health systems of these and other countries may encounter.
Resumo Objetivou-se identificar as ações desenvolvidas pelos sistemas de saúde do Brasil e da Itália para o enfrentamento da pandemia por COVID19. Trata-se de uma revisão integrativa da literatura nas bases de dados Web of Science, Scopus, Pubmed e Biblioteca Virtual de Saúde, com adição da técnica snowball, em julho de 2020. Após a coleta, 48 publicações constituíram a amostra. As ações dos sistemas de saúde dos dois países para o enfrentamento da pandemia foram agrupadas nas categorias: Adequação do normativo legal do sistema de saúde; Ampliação e fortalecimento do sistema de saúde; Uso das Tecnologias da Informação e Comunicação; Estímulo às medidas individuais e coletivas para enfrentamento da pandemia; e Limitações e desafios no enfrentamento da pandemia. As medidas adotadas são influenciadas pelos contextos político, econômico e social. Houve a reorganização da rede hospitalar nos dois países, mas identificam-se fragilidades nas ações preventivas desenvolvidas pela Atenção Primária à Saúde, predominando o modelo biomédico. A telemedicina destacou-se neste cenário e poderá perdurar no pós-pandemia. A sumarização das ações subsidiará o enfrentamento de outras pandemias com que, eventualmente, os sistemas de saúde destes e de outros países possam se deparar.
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Humanos , Estratégias de Saúde Nacionais , Telemedicina , Atenção à Saúde , Sistemas Nacionais de Saúde , Pandemias/prevenção & controle , COVID-19/prevenção & controle , Atenção Primária à Saúde , Sistema Único de Saúde , Brasil , Política de Saúde , ItáliaRESUMO
A água para consumo humano é um bem indispensável à vida, reconhecida pela Organização das Nações Unidas como direito humano fundamental, figura como metas dos Objetivos do Desenvolvimento Sustentável, ao orientar o acesso a água segura para todos e a eliminação de doenças transmitidas pela água até 2030. A qualidade da água é um fator de proteção à saúde e é dada mediante requisitos essenciais orientados pelos países, ou baseados nas diretrizes publicadas pela Organização Mundial da Saúde, traduzidos no padrão de qualidade e potabilidade. É recomendado que a água para consumo humano seja objeto de ações de vigilância e com isso, torna-se relevante mapear como estas ações vem sendo desenvolvidas no cenário mundial. O objetivo da tese é mapear as ações de vigilância da qualidade da água para consumo humano desenvolvidas por órgãos governamentais ou serviços de saúde pública. Como objetivos específicos: a) Propor um protocolo de scoping review para identificar e mapear ações e iniciativas mundiais de vigilância da qualidade da água potável implementadas por órgãos governamentais ou serviços de saúde pública; b) Identificar ações e iniciativas de vigilância da qualidade da água potável implementadas por órgãos governamentais ou serviços públicos de saúde. Trata-se de uma scoping review, baseada nas recomendações do Joanna Briggs Institute. Foram seguidas as 9 etapas: definição e alinhamento dos objetivos e questões da pesquisa; desenvolvimento e alinhamento de critérios de inclusão; descrição da seleção de evidências; busca de evidências; seleção de evidências; extração de evidências; análise de evidências; apresentação de resultados; resumo das evidências, conclusões e implicações dos achados. Foi feita a consulta aos stakeholders, para socialização dos resultados da revisão. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes. Os resultados subsidiaram a escrita de dois artigos, sendo (1) "Vigilância da qualidade da água potável em todo o mundo: protocolo de revisão de escopo" e (2) "Ações e iniciativas de Vigilância da Qualidade da Água para Consumo Humano em todo o mundo: Scoping review. O protocolo de estudo destacou as características e etapas metodológicas que orientaram a revisão, favorecendo a replicabilidade, confiabilidade do processo de pesquisa, conferindo rigor científico ao trabalho. A scoping review, identificou e mapeou as ações de vigilância da qualidade da água para consumo humano desenvolvidas, seus impactos e resultados, produzindo quatro classes: (1) avaliação da cobertura, acessibilidade, quantidade e qualidade da água para consumo humano em situações de rotina e emergências; (2) análise dos parâmetros físico-químicos e microbiológicos em redes de abastecimento público e soluções alternativas de abastecimento de água; (3) Identificação de contaminação domiciliar da água, comunicação e educação com a comunidade e (4) Investigação de surtos de doenças transmitidas pela água, que detalharam importantes ações e resultados nos países, permitindo a comparabilidade e identificação dos principais desafios objetos destas ações. O estudo identificou temas importantes que precisam ser analisados para que as ações de vigilância da qualidade da água para consumo humano possam contribuir para o acesso seguro a água (AU).
Drinking water is indispensable for life, recognized by the United Nations as a fundamental human right, it is one of the goals of the Sustainable Development Goals, as it guides access to safe water for all and the elimination of water-borne diseases until 2030. Water quality is a health protection factor and is given through essential requirements oriented by countries, or based on guidelines published by the World Health Organization, translated into the standard of quality and potability. It is recommended that drinking water be the object of surveillance actions and with that, it becomes relevant to analyze how these actions have been developed on the world stage. The objective of this thesis is to map the actions of surveillance of the drinking water quality developed by government agencies or public health services. As specific objectives: a) Propose a scoping review protocol to identify and map global actions and initiatives to monitor the quality of drinking water implemented by government agencies or public health services; b) Identify drinking water quality surveillance actions and initiatives implemented by government agencies or public health services. This is a scoping review, based on recommendations from the Joanna Briggs Institute. The 9 steps were followed: definition and alignment of research objectives and questions; development and alignment of inclusion criteria; description of evidence selection; search for evidence; evidence selection; evidence extraction; evidence analysis; results presentation; summary of evidence, conclusions and implications of findings. Stakeholders were consulted to share the results of the review. The study was approved by the Research Ethics Committee of the Hospital Universitário Onofre Lopes. The results supported the writing of two articles, being (1) "Surveillance of Drinking Water Quality Worldwide: Scoping Review Protocol" and (2) "Worldwide surveillance actions and initiatives of drinking water quality: a scoping review". The study protocol highlighted the characteristics and methodological steps that guided the review, favoring replicability and reliability of the research process, providing scientific rigor to the work. The scoping review identified and mapped the drinking water quality surveillance actions developed, their impacts and results, producing four classes: (1) evaluation of coverage, accessibility, quantity and quality of water for human consumption in situations routine and emergencies; (2) analysis of physical-chemical and microbiological parameters in public supply networks and alternative water supply solutions; (3) Identification of household water contamination, communication and education with the community and (4) Investigation of outbreaks of water-borne diseases, which detailed important actions and results in the countries, allowing the comparability and identification of the main challenges object of these actions. The study identified important issues that need to be analyzed so that drinking water quality surveillance actions can contribute to safe access to water (AU).
Assuntos
Abastecimento de Água , Água Potável/análise , Monitoramento da Água , Vigilância em Saúde Pública , Política de SaúdeRESUMO
Objetivou-se analisar o conhecimento dos familiares dos pacientes com tuberculose sobre a doença. Estudo epidemiológico descritivo de corte transversal realizado com a aplicação de questionário a 50 familiares de pacientes diagnosticados com tuberculose em Natal - RN entre os meses março e agosto de 2012. Os dados foram analisados através de frequências, percentuais, medidas de tendência central e cruzamento de variáveis dicotômicas com os testes Qui-Quadrado e teste de Fisher. Dentre os entrevistados, 34 (68%) disseram possuir pouco conhecimento e 11 (22%) nenhum conhecimento sobre a tuberculose. Quanto ao tempo de transmissão da doença, 20 (40%) deram uma resposta errada. Conclui-se que o conhecimento expresso pelos familiares sobre a tuberculose em alguns aspectos, foi satisfatório. Entretanto, suscitou características preocupantes em relação. Frente a esse cenário é imprescindível a promoção e disseminação da informação sobre a doença, como forma de controle da tuberculose (AU).
The article aimed to analyze the knowledge of the family members of the patients with tuberculosis regarding this disease. It is an epidemiological, descriptive and transversal study undertaken through a questionnaire applied to 50 family members of patients diagnosed with tuberculosis in Natal (State of Río Grande do Norte RN) between March and August 2012. The data were analyzed through frequencies, percentages, measurements of central tendency and the combining of dichotomous variables using the Chi-squared test and Fisher's exact test. Among the interviewees, 34 (68%) stated that they had little knowledge, and 11 (22%) that they had no knowledge, regarding tuberculosis. In relation to the infectious period of the disease, 20 (40%) gave incorrect responses. It is concluded that the knowledge expressed by the family members regarding tuberculosis was satisfactory in certain aspects. However, it raised worrying characteristics in relation to the disease. In this scenario, it is essential to promote and disseminate information regarding the disease, as a form of controlling tuberculosis (AU).
El objetivo del estudio fue analizar el conocimiento de los familiares de pacientes con tuberculosis acerca de la enfermedad. Estudio epidemiológico descriptivo transversal realizado por medio de cuestionario a 50 familiares de pacientes con diagnóstico de tuberculosis en Natal-RN, entre los meses de marzo y agosto de 2012. Los datos fueron analizados considerándose frecuencias, porcentuales, medidas de tendencia central y cruzamiento de variables dicotómicas con los testes Chi-Cuadrado y test de Fisher. Entre los entrevistados, 34 (68%) afirmaron tener poco conocimiento y 11 (22%) ningun conocimiento sobre tuberculosis. Cuanto al tiempo de transmisión de la enfermedad, 20 (40%) contestaron equivocadamente. Se concluye que el conocimiento expreso por los familiares sobre la tuberculosis en algunos aspectos fue satisfactorio. Sin embargo, se revelaron características preocupantes acerca de eso. Delante del cuadro, son imprescindibles la promoción y divulgación de la información acerca de la enfermedad, como forma de control de la tuberculosis (AU).
Assuntos
Humanos , Atenção Primária à Saúde , Tuberculose , Cuidados de EnfermagemRESUMO
A tuberculose é uma doença infecciosa e contagiosa intimamente relacionada a condições de pobreza, tendo como um dos maiores problemas o abandono do tratamento. Com o objetivo de descrever os principais fatores associados ao abandono do tratamento da tuberculose pulmonar apontados pela literatura científica, se realizou esta revisão integrativa. Os resultados apontam a história de abandono prévio, uso de álcool e outras drogas, baixa escolaridade e melhora dos sintomas clínicos da doença como os principais fatores associados ao abandono. A identificação das pessoas com maior risco para abandonar o tratamento, deve ser prática no cotidiano dos serviços de saúde, em especial na atenção básica, que atualmente é a grande responsável pelo controle da tuberculose no Brasil.
Tuberculosis is an infectious and contagious disease deeply related to poverty, having as one of the most important problems the treatment dropout. In order to describe the main factors associated with treatment abandonment of pulmonary tuberculosis appointed by the scientific literature, this integrative review was performed. The results show the history of previous noncompliance, use of alcohol and other drugs, low education and improvement of the clinical symptoms of the disease as main factors associated with noncompliance. The identification of individuals at higher risk for abandoning treatment should be practical in everyday health services, especially in primary care, which is currently largely responsible for tuberculosis control in Brazil.
La tuberculosis es una enfermedad infecciosa y contagiosa muy relacionada con las condiciones de pobreza, teniendo como uno de los mayores problemas el abandono del tratamiento. A fin de describir los principales factores asociados con el abandono del tratamiento de la tuberculosis pulmonar señalados por la literatura científica, se realizó esta revisión integradora. Los resultados muestran la historia de abandono previo, el uso de alcohol y otras drogas, el bajo nivel educativo y la mejora de los síntomas clínicos de la enfermedad como los principales factores asociados con el abandono. La identificación de las personas en mayor riesgo de abandono del tratamiento debe ser práctica en los servicios de salud, especialmente en la atención primaria que actualmente es en gran medida responsable del control de la tuberculosis en Brasil.
Assuntos
Humanos , Pacientes Desistentes do Tratamento , Atenção Primária à Saúde , Tuberculose Pulmonar , RevisãoRESUMO
Analisar publicações sobre cuidado de enfermagem a pacientes adultos em Unidades de Terapia Intensiva no período de 2005 à 2010. Método: Revisão integrativa, a partir da análise de artigos publicados nas bases de dados da Biblioteca Virtual de Saúde (BVS), Base de Dados da Enfermagem (BDENF) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Utilizou-se para a busca os termos cuidados de enfermagem, terapia intensiva e saúde do adulto. Resultados: Identificou-se 1093 artigos, destes apenas 13 artigos disponíveis na íntegra. Com a análise dos trabalhos extraiu-se 3 categorias para discussão: Gerenciamento do cuidado de Enfermagem, Cuidado de Enfermagem com pacientes, Cuidado de Enfermagem com familiares. Conclusão: Percebe-se que o cuidado prestado aos pacientes adultos não se restringe apenas a seu processo patológico, mas também inclui o gerenciamento do cuidado e amplia este aos familiares dos pacientes.
Analizar publicaciones sobre cuidados de enfermería a pacientes adultos en unidades de cuidados intensivos desde 2005 hasta 2010. Métodos: Revisión Integral, basado en artículos publicados en las bases de datos de la Biblioteca Virtual en Salud (BVS), Base de Datos de Enfermería (BDENF) y el Centro Latinoamericano y del Caribe en Ciencias de la Salud (LILACS). Se utilizó para búsqueda los términos cuidado de enfermería, cuidados intensivos y salud de los adultos. Resultados: Se identificaron 1093 artículos, pero sólo 13 artículos disponibles. Con el análisis se extraen tres categorías para la discusión: Gestión de los cuidados de enfermería, cuidados de enfermería a los pacientes, cuidados de enfermería con sus familiares. Conclusión: Se considera que la atención brindada a los pacientes adultos no se limita a su proceso de enfermedad, sino que también incluye la gestión de la atención y esto se extiende a los familiares de los pacientes.
Objective: To analyze publications on nursing care to adult patients in intensive care units from 2005 to 2010. Method: Integrative review, based on an analysis of articles published in the databases of the Virtual Health Library (VHL), Database of Nursing (BDENF) and the Latin American and Caribbean Health Sciences (LILACS). Was used for the search terms nursing care, intensive care and adult health. Results: We identified 1093 articles, of which only 13 items available in their entirety. With the analysis of the work was extracted three categories for discussion: Management of Nursing Care, Nursing Care to patients, nursingcare with relatives. Conclusion: It is felt that the care provided to adult patients is not restricted to their disease process, but also includes the careful management and extends this to the families of patients.