Accessibility to the treatment of hypertension in the family health strategy. / Acessibilidade ao tratamento da hipertensão arterial na estratégia saúde da família.

OBJECTIVE: To analyze the satisfaction about the accessibility to the treatment of people with hypertension accompanied by the Family Health Strategy. METHOD: Cross-sectional study, conducted with 417 people living in a city in the state of Paraná, Brazil. The data collection was performed between February and June of 2016, using a satisfaction instrument regarding the services provided by the Primary Health Care, using issues related to treatment accessibility. A descriptive and inferential analysis to treat the variables was adopted. RESULTS: 417 people participated in the study, from which 62.4% were elderly, 67.8% were female and 55.2% were retired/pensioners. The economic accessibility was the best evaluated indicator. The regular evaluation of the services characteristic of the geographical and organizational accessibility was significantly associated to the inadequate monitoring of these users in the Family Health Strategy. CONCLUSION: The services offered to people with arterial hypertension were evaluated as regular, presenting the main barriers related to geographical and organizational aspects.

Design of Innovative Clothing for Pressure Injury Prevention: End-User Evaluation in a Mixed-Methods Study.

The global relevance of pressure injury (PI) prevention technologies arise from their impact on the quality of life of people with limited mobility and the costs associated with treating these preventable injuries. The purpose of this mixed methods study is to evaluate the design of a prototype integrating Smart Health Textiles for PI prevention based on feedback from specialist nurses who care for individuals who are prone to or have PIs. This is a mixed methods study. A structured questionnaire was conducted as part of an evaluation of a prototype garment for the prevention of PIs. This questionnaire was applied during the evaluation of the prototype and afterwards focus group discussions were held with experts. Descriptive statistics techniques were used to analyze the data and thematic and integrated content analysis was conducted through concomitant triangulation. Nineteen nurses took part, aged 30 to 39 years (52.6%) and with 12.31 ± 8.96 years of experience. Participants showed that the prototype required more manipulation and physical effort, which interfered its usefulness, in addition to presenting difficulties with the openings and the material of the closure system, which interfered with the ease of use and learning. Overall satisfaction with the product was moderate, with some areas for improvement found, such as satisfaction, recommendations to colleagues, and pleasantness of use. It is concluded that areas for improvement have been found in all dimensions, including in the design of openings and the choice of materials. These findings supply significant insights for improving clothing to meet the needs of healthcare professionals and patients.

Development of Smart Clothing to Prevent Pressure Injuries in Bedridden Persons and/or with Severely Impaired Mobility: 4NoPressure Research Protocol.

Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care.

Factors associated with the skills of informal caregivers in home care.

OBJECTIVE: To identify factors associated with cognitive, emotional, psychomotor, and relational skills of informal caregivers in home care. METHODS: A cross-sectional study carried out with a sample of 216 informal caregivers residing in a municipality in the state of Paraná. Data collection took place between February and July 2019, with an instrument developed and validated to assess the skills of informal caregivers. Descriptive and inferential analyses were used. RESULTS: The factors associated with a greater competence of informal caregivers were being female, having training in the field, and having more than five years home care experience. The lowest competence was observed in caregivers who had health problems and belonged to the lowest strata of family purchasing power. Participants had lower scores in psychomotor competence and had better results in cognitive competence. CONCLUSION: It was found that women with experience in care had higher levels of competence to provide quality care at home assistance services.

Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory.

OBJECTIVES: to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity. METHODS: this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework. RESULTS: two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon "Re-signifying life after bariatric surgery" was constructed. FINAL CONSIDERATIONS: bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.

Validation of the Informal Caregiver Burden Assessment Questionnaire for Brazil - short version.

OBJECTIVES: to cross-culturally adapt the short version of the Informal Caregiver Burden Assessment Questionnaire to the Brazilian culture and test its psychometric properties. METHODS: the questionnaire was translated, adapted, and applied to a sample of 280 informal caregivers. The psychometric assessment was verified by estimating psychometric sensitivity and internal structure validity. RESULTS: inter-rater agreement was satisfactory among specialists. In the seven-factor model, item (Q9) of the domain "Perception of Efficacy and Control Mechanisms" showed a factor loading less than 0.40 (ʎ = 0.26), and an alternative six-factor model was evaluated. However, both models showed excellent fit indices, and it was decided to keep the seven-factor reference model. Reliability was satisfactory for the seven subscales (α > 0.70). CONCLUSIONS: the questionnaire was adapted and showed adequate psychometric indices in the Brazilian context in which it was evaluated, preserving its original essence.

Construction and validation of self-care educational technology for caregivers.

OBJECTIVES: to build and validate educational self-care technology for informal caregivers. METHODS: methodological study, anchored in the Delphi technique, carried out in a municipality in the state of Paraná, Brazil, between September 2018 and November 2019. It was developed in three stages: situational diagnosis; elaboration of educational technology; content and appearance validation by expert judges and informal caregivers, using the content validity index and coefficient of variation. RESULTS: after the steps of the methodological process, an educational technology called "Taking Care of Those Who Care" was produced, as an information tool that deals with the self-care of informal caregivers, receiving a content validity index above 0.86 and a variation coefficient. below 20% on all items. CONCLUSIONS: the educational technology was built and evaluated with satisfactory rates by the specialists and target audience, showing a high correlation of agreement, characterizing it as adequate and informative to informal caregivers.

Effect of sleeve gastrectomy on lipid parameters and cardiometabolic risk in young women.

OBJECTIVE: to analyze the effect of vertical gastrectomy on lipid profile and cardiometabolic risk in young women, preoperatively and 6 months after the operation. METHODS: retrospective study, encompassing medical record reviews of women's charts, preoperatively and in six months after the operation. Data collection was performed in the second half of 2015, using a review protocol with questions on the clinical-laboratory profile, anthropometric and laboratory classification of dyslipidemias. Descriptive and inferential analysis were used to treat the variables, using measures of variance, association and linear regression. RESULTS: we analyzed medical records of 114 women undergoing vertical gastrectomy, with a mean age of 33.82±10.92, and with complete high school education. There was a significant reduction of anthropometric data, as well as serum lipid values, six months after the surgical procedure. The coefficients of determination and the results of linear regression, showed that the reduction in serum triglyceride values and increase in high-density lipoprotein have a direct impact on the reduction of the cardiometabolic risk. Regarding the laboratory classification of dyslipidemias, it was observed that the majority presented a significant reduction at the six-month follow-up. Mixed hyperlipidemia showed no significant reduction. The categorized cardiometabolic risk showed a significant reduction in women at risk before vertical gastrectomy. CONCLUSION: at the six-month follow-up, vertical gastrectomy was effective in reducing the serum lipid profile and the cardiometabolic risk of young women when compared to the preoperative data. There was also a different improvement in the laboratory classification of dyslipidemias at the six-month follow-up after the surgical procedure.

Factors associated with the use of potentially inappropriate medications by elderly people with hypertension.

OBJECTIVE: to analyze factors associated with the use of potentially inappropriate medications by elderly people with hypertension. METHOD: a cross-sectional study, conducted in the first semester of 2016, with elderly people undergoing treatment for hypertension, living in the city of Maringá. Interviews, medical records analysis, and measurement of clinical and anthropometric parameters of the participants were carried out. Inferential analysis was used. RESULTS: a total of 260 elderly people who used potentially inappropriate medications participated in the study. The high use of these medications was associated with clinical and anthropometric conditions, such as obesity (p=0.022), smoking (p=0.004), polypharmacy (p=0.034) and the health services provided, such as organizationally accessible treatment (p=0.027) and consultation time (p=0.007), predisposing to low adherence to routine consultations (p=0.003). CONCLUSION: it was shown that the factors associated with the use of potentially inappropriate medications were associated with anthropometric, clinical, and organizational variables, intrinsic to the family health strategy.

Conicity index in people with hypertension followed in the Brazil's Family Health Strategy.

OBJECTIVES: to analyze the conicity index in people with hypertension followed in the Brazil's Family Health Strategy. METHODS: cross-sectional study conducted in a medium-sized municipality located in the state of Paraná. Data collection took place in the first semester of 2016. using an adapted and validated instrument. which addresses attributes of Primary Health Care. Sociodemographic and anthropometric variables and blood pressure were used in the study. The analysis of variance and linear regression was used to analyze the variables. RESULTS: a total of 417 people participated in the study. most were women. elderly. married. with less than eight years of education and retired. Conicity index was prevalent in most of the study population. being significantly associated with the group of people with inadequate blood pressure control and high anthropometric parameters. CONCLUSIONS: most of the study participants had altered conicity index. especially those with inadequate blood pressure control.

Distribution and spatial autocorrelation of the hospitalizations for cardiovascular diseases in adults in Brazil.

OBJECTIVES: To analyze the distribution and spatial autocorrelation of the hospitalization rates for cardiovascular diseases in adults, and to verify the correlation with socioeconomic and health factors in Brazil. METHODS: An ecological study of hospitalization rates for cardiovascular diseases in adults from 2005 to 2016. Spatial dependence was analyzed by the Moran Global and Local autocorrelation coefficients. The correlation between hospitalization rates and socioeconomic and health variables was calculated using the Spearman's correlation coefficient. RESULTS: The highest hospitalization rates were observed in the states of Santa Catarina, Paraná, São Paulo, and Mato Grosso, with high-high autocorrelation clusters for ischemic heart disease. The hospitalizations for cardiovascular diseases were strongly correlated with low schooling, alcohol consumption, and diagnosis of hypertension. CONCLUSION: The high rates of hospitalization in the states mentioned, linked to socioeconomic and health factors, suggest public policies focused on the theme.

Adherence of hypertension patients in the Brazil's Family Health Strategy.

OBJECTIVE: to evaluate the adherence and associate it to blood pressure control and to follow-up observation of people with hypertension in the Brazil's Family Health Strategy. METHOD: cross-sectional study, conducted with 417 people in treatment of hypertension, living in a municipality located in the Northwest region of the state of Paraná, Brazil. The data were collected in the first 2016 semester, using an instrument adapted and validated for the evaluation of satisfaction with the services offered by Primary Health Care. Analysis of variance and the logistic regression model were used for the treatment of variables. RESULTS: it was evidenced that people with inadequate follow-up observation evaluate the relations between professional/user and the guidance to the medications used as unsatisfactory. CONCLUSION: weak guidelines and ineffective dialogue between health professionals and users might result in an inadequate follow-up observation of blood pressure control and of people with hypertension.

Use of grounded theory in the extraction, coding and analysis of data in literature meta-analyses / Aplicabilidad de la teoría fundamentada en la extracción, análisis y codificación de datos en meta-análisis de literatura / Utilização da grounded theory na extração, codificação e análise de dados em metassínteses de literatura

ABSTRACT Objective: to describe the conduction of data extraction, analysis and codification using the Straussian perspective of Grounded Theory, in Literature Meta-analysis. Method: this is a theoretical-reflexive study on the data extraction from reviews with meta-anaylses. To design the process of searching for qualitative studies, this study briefly addresses the sequential steps of Preferred Reporting Items for Systematic Review and Meta-Analyses and the Joanna Briggs Institute. The extraction, analysis and codification process were carried out following the assumptions of grounded theory, with the Straussian perspective. They are the theoretical-methodological bases in the first stages of the guidelines of the literature review and Meta-analyses guides, starting with the research question until reaching the review stages, divided into identification, selection, eligibility, and inclusion. Results: the results describe the process of data extraction, analysis and codification from the Straussian perspective, using comparative analysis of data, memoranda, diagrams and possibilities of new sample groups from the detailed analytical reading of the included studies. Finally, theoretical saturation is performed, with an analysis of the findings, with examples of categories and subcategories, the emergence of the central phenomenon and presentation of the paradigmatic model. Conclusion: the essay presents subsidies for the understanding of the conduction of extraction, analysis and codification of data in meta-analyses based on the Straussian perspective, enabling the systematized analysis of qualitative evidence and contributing to the development of models or theories of conceptual character

RESUMEN Objetivo: describir la conducta de extracción, análisis y codificación de datos utilizando la Teoría Fundamentada, en la perspectiva Straussiana, en la Metasíntesis de la Literatura. Método: se trata de un ensayo teórico-reflexivo sobre la conducción de la extracción de datos a partir de revisiones de metasíntesis. Para delinear el proceso de búsqueda de estudios cualitativos, este ensayo aborda brevemente los pasos secuenciales de los Elementos de informe preferidos para la revisión sistemática y los metanálisis y el Instituto Joanna Briggs. El proceso de extracción, análisis y codificación se realizó siguiendo los supuestos de la Grounded Theory, con la perspectiva straussiana. Son las bases teórico-metodológicas en las primeras etapas de los lineamientos de las guías de revisión de literatura y Metasíntesis, partiendo de la pregunta de investigación hasta llegar a las etapas de revisión, divididas en identificación, selección, elegibilidad e inclusión. Resultados: los resultados describen el proceso de extracción, análisis y codificación de datos desde la perspectiva straussiana, utilizando análisis de datos comparativos, memorandos, diagramas y posibilidades de nuevos grupos de muestra a partir de una lectura analítica exhaustiva de los estudios incluidos. Finalmente, se realiza una saturación teórica, con una síntesis de los hallazgos, con ejemplos de categorías y subcategorías, emergencia del fenómeno central y presentación del modelo paradigmático. Conclusión: el ensayo presenta subsidios para la comprensión de la extracción, análisis y codificación de datos en Metasíntesis a partir de la perspectiva straussiana, permitiendo, de forma sistemática, la síntesis de evidencias cualitativas y contribuyendo al desarrollo de modelos o teorías de carácter conceptual. naturaleza.

RESUMO Objetivo: descrever a condução de extração, análise e codificação de dados utilizando a Grounded Theory, na perspectiva Straussiana, em Metassínteses de literatura. Método: trata-se de um ensaio teórico-reflexivo sobre a condução da extração de dados de revisões com metassíntese. Para delineamento do processo de busca dos estudos qualitativos, este ensaio aborda, de forma sucinta, as etapas sequenciais do Preferred Reporting Items for Systematic Review and Meta-Analyses e da Joanna Briggs Institute. O processo de extração, análise e codificação foi realizado seguindo os pressupostos da Grounded Theory, com a perspectiva Straussiana. São as bases teórico-metodológicas nas primeiras etapas das diretrizes dos guias de revisão de literatura e Metassíntese, iniciando com a pergunta de pesquisa até chegar às etapas da revisão, divididas em identificação, seleção, elegibilidade e inclusão. Resultados: nos resultados são descritos o processo de extração, análise e codificação de dados na perspectiva Straussiana, com uso de análise comparativa dos dados, memorandos, diagramas e possibilidades de novos grupos amostrais a partir da leitura analítica minuciosa dos estudos inclusos. Por fim, é realizada a saturação teórica, com síntese dos achados, com exemplos de categorias e subcategorias, emersão do fenômeno central e apresentação da modelo paradigmático. Conclusão: o ensaio apresenta subsídios para a compreensão da condução de extração, análise e codificação de dados em Metassínteses baseada na perspectiva Straussiana, possibilitando, de forma sistematizada, a síntese de evidências qualitativas e contribuindo no desenvolvimento de modelos ou teorias de caráter conceitual.

Medidas antropométricas associadas ao tempo de encarceramento de pessoas privadas de liberdade / Medidas antropométricas relacionadas con el tiempo de encarcelamiento de personas privadas de la libertad / Anthropometric measures associated with incarceration length of persons deprived of their liberty

Resumo Objetivo Analisar as medidas antropométricas associadas ao tempo de encarceramento de pessoas privadas de liberdade. Métodos Estudo transversal, realizado com 220 homens privados de liberdade. Os dados foram coletados por meio de instrumento que abrangia informações do encarceramento atual, sociodemográficas e das condições de vida antes do encarceramento, além de aferição de medidas antropométricas. Utilizaram-se estatística descritiva, testes de associações e ajuste de modelos de regressão logística binária controlados pelo tempo de encarceramento (até 1ano e mais de 1ano). Resultados Houve associação significativa entre o tempo de encarceramento e a circunferência abdominal (RC de 0,41; IC95%0,16-0,97). Os resultados da correlação de Spearman apontaram que, à medida que aumentou o tempo de encarceramento, as medidas antropométricas diminuíram, com relação negativa de fraca magnitude e significativa apenas para o índice de conicidade (r=-0,1648; p=0,0144). Os modelos ajustados controlados pelo tempo de encarceramento mostraram associações significativas com idade em anos (RC de 1,08; IC95%=1,04;1,12) e circunferência abdominal; idade (RC de 1,08; IC95%1,04-1,12) e razão cintura e estatura; e idade (RC de 1,10; IC95%1,06-1,14), anos de estudo (RC de 2,17; IC95%1,10-4,26) e possuir parceiro(a) (RC de 0,46; IC95%0,22-0,93) com o índice de conicidade. Conclusão À medida que aumenta o tempo de encarceramento, há redução das medidas antropométricas das pessoas privadas de liberdade. As variáveis antropométricas influenciam diretamente no desenvolvimento de doenças crônicas não transmissíveis e devem ser monitoradas para elaboração de estratégias que minimizem os riscos e os agravos à saúde dessa população vulnerável.

Resumen Objetivo Analizar las medidas antropométricas relacionadas con el tiempo de encarcelamiento de personas privadas de la libertad. Métodos Estudio transversal, realizado con 220 hombres privados de la libertad. Los datos fueron recopilados mediante un instrumento que incluía información del encarcelamiento actual, sociodemográfica y de las condiciones de vida antes del encarcelamiento, además de la comparación de medidas antropométricas. Se utilizó estadística descriptiva, pruebas de asociación y ajuste de modelos de regresión logística binaria controlados por el tiempo de encarcelamiento (hasta 1 año y más de 1 año). Resultados Hubo asociación significativa entre el tiempo de encarcelamiento y la circunferencia abdominal (RC de 0,41; IC95%0,16-0,97). Los resultados de la correlación de Spearman indicaron que, a media que aumentaba el tiempo de encarcelamiento, las medidas antropométricas disminuían, con relación negativa de escasa magnitud y significativa para el índice de conicidad (r=-0,1648; p=0,0144). Los modelos ajustados controlados por el tiempo de encarcelamiento mostraron asociaciones significativas con la edad en años (RC de 1,08; IC95%=1,04;1,12) y circunferencia abdominal; edad (RC de 1,08; IC95%1,04-1,12) y razón de cintura y estatura; y edad (RC de 1,10; IC95%1,06-1,14), años de estudio (RC de 2,17; IC95%1,10-4,26) y tener pareja (RC de 0,46; IC95%0,22-0,93) con el índice de conicidad. Conclusión A medida que aumenta el tiempo de encarcelamiento, hay una reducción de las medidas antropométricas de las personas privadas de la libertad. Las variables antropométricas influyen directamente en el desarrollo de enfermedades crónicas no transmisibles y deben controlarse para la elaboración de estrategias que minimicen los riesgos y los agravios a la salud de esta población vulnerable.

Abstract Objective To analyze the anthropometric measures associated with incarceration length of people deprived of their liberty. Methods This is a cross-sectional study carried out with 220 men deprived of their liberty. Data were collected using an instrument that included information on current incarceration, sociodemographic information and living conditions before incarceration, in addition to measuring anthropometric measures. Descriptive statistics, association tests and adjustment of binary logistic regression models controlled by incarceration length (up to 1 year and more than 1 year) were used. Results There was a significant association between incarceration length and abdominal circumference (OR 0.41; 95%CI 0.16-0.97). The results of Spearman's correlation showed that, as the incarceration length increased, the anthropometric measures decreased, with a negative relationship of weak magnitude and significant only for the conicity index (r=-0.1648; p=0.0144). Adjusted models controlled for incarceration length showed significant associations with age in years (OR 1.08; 95%CI=1.04;1.12) and abdominal circumference; age (OR 1.08; 95%CI 1.04-1.12) and waist-to-height ratio; and age (OR 1.10; 95%CI 1.06-1.14), years of education (OR 2.17; 95%CI 1.10-4.26) and having a partner (OR 0 .46; 95%CI0.22-0.93) with the conicity index. Conclusion As incarceration length increases, there is a reduction in the anthropometric measures of persons deprived of their liberty. Anthropometric variables directly influence the development of non-communicable chronic diseases and must be monitored to develop strategies that minimize the risks and health problems of this vulnerable population.

Analysis of obese patients' medical conditions in the pre and postoperative periods of bariatric surgery.

Objective: to compare the clinical conditions of obese patients in the pre and postoperative period of bariatric surgery. Methods: we carried out a descriptive, retrospective, quantitative study by consulting the charts of 134 patients who underwent bariatric surgery in the period from 2009 to 2014. We collected the data between September and November 2015. We performed a descriptive statistical analysis and comparative analysis of anthropometric, metabolic, biochemical and clinical variables, considering six months before and after surgery. Results: the majority of the patients were female (91.8%), with a higher prevalence (35%) in the age group 18-29 years old, complete high-school education (65.6%) and grade III obesity (60.4%). Six months after surgery, weight and lipid profile reduction were significant in both genders, but the impact on biochemical, anthropometric, metabolic and clinical parameters was significant only in female subjects, with a reduction in morbidities associated with obesity, such as arterial hypertension, diabetes mellitus, dyslipidemia and metabolic syndrome and in the use of drugs to control them. Conclusion: bariatric surgery was effective in weight loss, with improvements in anthropometric, metabolic and biochemical parameters and in the reduction of morbidities associated with obesity.

Objetivo: comparar as condições clínicas de pacientes obesos em período pré e pós-operatório de cirurgia bariátrica. Método: estudo descritivo, retrospectivo, de abordagem quantitativa, por meio de consulta ao prontuário de 134 pacientes submetidos à cirurgia bariátrica no período de 2009 a 2014. Os dados foram coletados entre os meses de setembro e novembro de 2015. Foi realizada análise estatística descritiva e comparativa das variáveis antropométricas, metabólicas, bioquímicas e clínicas, considerando seis meses antes e após a cirurgia. Resultados: a maioria dos pacientes era do sexo feminino (91,8%), com maior prevalência (35%) na faixa etária de 18 aos 29 anos, com ensino médio completo (65,6%) e obesidade grau III (60,4%). Seis meses após a cirurgia, a redução do peso e o perfil lipídico foram significativos em ambos os sexos, mas o impacto nos parâmetros bioquímicos, antropométricos, metabólicos e clínicos foi significativo apenas nos indivíduos do sexo feminino, com redução das morbidades associadas à obesidade como hipertensão arterial, diabetes mellitus, dislipidemia e síndrome metabólica e na utilização de medicamentos. Conclusão: a cirurgia bariátrica foi eficaz na perda ponderal de peso, com melhoras nos parâmetros antropométricos, metabólicos e bioquímicos e na redução de morbidades associadas à obesidade.

Coordenação do cuidado na perspectiva das pessoas com hipertensão na atenção primária à saúde / Coordination of care from the perspective of people with hypertension in primary health care

Objetivo: analisar a satisfação de pessoas com hipertensão acerca da coordenação do cuidado na Atenção Primária à Saúde. Método: trata-se de um estudo transversal, realizado com 417 pessoas em um município de médio porte, locali-zado na região sul do Brasil. Os dados foram coletados no primeiro semestre de 2016, utilizando instrumento de avaliação adaptado e validado sobre domínios estruturais da Atenção Primária à Saúde e utilizado questões referentes à coordena-ção do cuidado. Realizou-se análise descritiva e inferencial para tratamento das variáveis. Resultados: evidenciou-se que os entrevistados avaliaram satisfatoriamente a utilização dos prontuários durante a consulta por parte dos profissionais de saúde e discussão dos resultados oriundos da consulta no serviço especializado. Pessoas com controle pressórico inade-quado avaliaram insatisfatoriamente a anotação das queixas e necessidades em saúde, verbalizadas durante as consultas, agendamento para retorno e encaminhamento por escrito de competência das Unidades Básicas de Saúde, como também, atendimento garantido e informações esclarecedoras sobre os resultados da consulta no serviço referenciado. Conclusão:As pessoas com hipertensão apresentaram satisfação com a coordenação do cuidado na Atenção Primária à Saúde (AU)

Objective: to analyze the satisfaction of people with hypertension about the coordination of care in Primary Health Care. Method: this is a cross-sectional study conducted with 417 people in a medium-sized municipality located in the southern region of Brazil. Data were collected in the first half of 2016, using an evaluation instrument adap-ted and validated on structural domains of Primary Health Care and used questions regarding the coordination of care. Descriptive and inferential analysis was performed to treat the variables. Results: it was evidenced that the interviewees satisfactorily evaluated the use of medical records during consultation by health professionals and discussion of results from the consultation in the specialized service. People with inadequate blood pressure control unsatisfactorily evaluated the recording of complaints and health needs verbalized during consultations, scheduling of return visits, and written referrals from the Basic Health Units, as well as guaranteed care and clarifying infor-mation about the results of the consultation in the referral service. Conclusion: People with hypertension showed satisfaction with the coordination of care in Primary Health Care (AU)

Competência de idosos cuidadores informais de pessoas em assistência domiciliar / Competencia de ancianos que se desempeñan como cuidadores informales de personas en cuidados domiciliarios / Competence of aged informal caregivers of people in home care

Resumo Objetivos analisar a estimativa condicional do conhecimento, adaptação e preparo nas competências de idosos que exercem o papel de cuidadores informais de pessoas dependentes de cuidado em assistência domiciliar. Método estudo transversal, realizado com idosos cuidadores informais, residentes no município de Maringá, Paraná, Brasil. A coleta de dados foi realizada entre maio e julho de 2019 com um instrumento que avalia as competências cognitivas, psicomotoras, emocionais e relacionais de cuidadores informais de pessoas dependentes de cuidado em assistência domiciliar. O instrumento é constituído por 14 itens e três construtos: conhecimento, adaptação e preparo, sendo a escala de resposta Likert de cinco pontos. Utilizou-se análise de regressão linear para tratamento das variáveis. Resultados participaram do estudo 101 idosos cuidadores informais, e as estimativas condicionais das competências cognitiva e relacional apresentaram maior correlação com adaptação e o preparo. O melhor conhecimento estima maior desenvolvimento da competência psicomotora e cognitiva nas práticas de cuidado. Conclusão e implicações para a prática os conceitos hipotéticos de conhecimento, adaptação e preparo explicam o melhor desempenho das competências cognitiva, relacional e psicomotora de idosos cuidadores informais. Este resultado possibilita o desenvolvimento de novas intervenções educativas aos idosos que desempenham o papel de cuidador informal.

Resumen Objetivos analizar la estimación condicional del conocimiento, adaptación y preparación en las habilidades de personas mayores que desempeñan el papel de cuidadores informales de personas dependientes de cuidados en el hogar. Método estudio transversal realizado con personas mayores que se desempeñan como cuidadores informales, residentes en la ciudad de Maringá, Paraná, Brasil. La recolección de datos se realizó entre mayo y julio de 2019 a través de un instrumento construido y validado que evalúa las habilidades de los cuidadores informales de personas dependientes de cuidados en el hogar. Se utilizó análisis de regresión lineal para tratar las variables. Resultados participaron del estudio 101 personas mayores, que obran como cuidadores informales y las estimaciones condicionales de las habilidades cognitivas y relacionales de las personas mayores mostraron mayor correlación con la adaptación y preparación. Un mejor conocimiento estima un mayor desarrollo de la competencia psicomotora y cognitiva de las personas mayores en las prácticas asistenciales. Conclusión e implicaciones para la práctica los conceptos hipotéticos de conocimiento, adaptación y preparación explican el mejor desempeño de las habilidades cognitivas, relacionales y psicomotoras de las personas mayores que actúan como cuidadores informales. Este resultado permite el desarrollo de nuevas intervenciones educativas para las personas mayores que desempeñan el papel de cuidadores informales.

Abstract Objectives to analyze the conditional estimate of knowledge, adaptation and preparation in the skills of aged people who play the role of informal caregivers of assistance-dependent individuals in home care. Method a cross-sectional study carried out with aged informal caregivers who live in the city of Maringá, Paraná, Brazil. Data collection was carried out between May and July 2019 through a constructed and validated instrument that assesses the skills of informal caregivers of assistance-dependent individuals in home care. Linear regression analysis was used to treat the variables. Results the study participants were 101 aged informal caregivers, in which the conditional estimates of the cognitive and relational skills of the aged person showed a greater correlation with adaptation and preparation. Better knowledge estimates greater development of the psychomotor and cognitive competence of the elderly in care practices. Conclusion and implications for the practice the hypothetical concepts of knowledge, adaptation and preparation explain the better performance of the cognitive, relational and psychomotor skills of aged informal caregivers. This result enables the development of new educational interventions for the elderly who play the role of informal caregivers.

Validation of the Informal Caregiver Burden Assessment Questionnaire for Brazil - short version / Validación del Cuestionario de Evaluación de la Sobrecarga del Cuidador Informal de Brasil - versión corta / Validação do Questionário de Avaliação da Sobrecarga do Cuidador Informal para o Brasil - versão curta

ABSTRACT Objectives: to cross-culturally adapt the short version of the Informal Caregiver Burden Assessment Questionnaire to the Brazilian culture and test its psychometric properties. Methods: the questionnaire was translated, adapted, and applied to a sample of 280 informal caregivers. The psychometric assessment was verified by estimating psychometric sensitivity and internal structure validity. Results: inter-rater agreement was satisfactory among specialists. In the seven-factor model, item (Q9) of the domain "Perception of Efficacy and Control Mechanisms" showed a factor loading less than 0.40 (ʎ = 0.26), and an alternative six-factor model was evaluated. However, both models showed excellent fit indices, and it was decided to keep the seven-factor reference model. Reliability was satisfactory for the seven subscales (α > 0.70). Conclusions: the questionnaire was adapted and showed adequate psychometric indices in the Brazilian context in which it was evaluated, preserving its original essence.

RESUMEN Objetivos: adaptar transculturalmente la versión corta del Cuestionario de Evaluación de la Sobrecarga del Cuidador Informal para cultura brasileña y probar sus propriedades psicométricas. Métodos: cuestionario traducido, adaptado y aplicado para 280 cuidadores informales. Evaluación psicométrica verificada por la estimativa de la sensibilidad psicométrica y validez de la estructura interna. Resultados: la concordancia interevaluadores fue satisfactoria entre los especialistas. En el modelo de siete factores, el ítem (Q9) del dominio "Percepción de los mecanismos de eficacia y control" presentó carga factorial menor que 0,40 (ʎ = 0,26), y un modelo alternativo de seis factores fue evaluado. Sin embargo, los dos modelos evidenciaron óptimos índices de ajustamiento, y se optó por mantener el modelo-referencia de siete factores. La confiabilidad se mostró satisfactoria para las siete subescalas (α > 0,70). Conclusiones: el cuestionario fue adaptado y demostró indicadores psicométricos satisfactorios en el contexto brasileño en que fue evaluado, preservando su esencia original.

RESUMO Objetivos: adaptar transculturalmente a versão curta do Questionário de Avaliação da Sobrecarga do Cuidador Informal para cultura brasileira e testar suas propriedades psicométricas. Métodos: o questionário foi traduzido, adaptado e aplicado em uma amostra de 280 cuidadores informais. A avaliação psicométrica foi verificada pela estimativa da sensibilidade psicométrica e validade da estrutura interna. Resultados: a concordância interavaliadores foi satisfatória entre os especialistas. No modelo de sete fatores, o item (Q9) do domínio "Percepção dos Mecanismos de Eficácia e Controle" apresentou carga fatorial menor do que 0,40 (ʎ = 0,26), e um modelo alternativo de seis fatores foi avaliado. No entanto, os dois modelos evidenciaram ótimos índices de ajustamento, e optou-se por manter o modelo-referência de sete fatores. A confiabilidade mostrou-se satisfatória para as sete subescalas (α > 0,70). Conclusões: o questionário foi adaptado e demonstrou índices psicométricos satisfatórios no contexto brasileiro em que foi avaliado, preservando sua essência original.

Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory / Significados atribuidos a los cambios ocurridos después de la cirugía bariátrica: un análisis a la luz de la Teoría Fundamentada / Significados atribuídos às mudanças ocorridas após a cirurgia bariátrica: uma análise à luz da Teoria Fundamentada

ABSTRACT Objectives: to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity. Methods: this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework. Results: two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon "Re-signifying life after bariatric surgery" was constructed. Final Considerations: bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.

RESUMEN Objetivos: comprender significados atribuidos a cambios vividos tras cirugía bariátrica por personas con obesidad. Métodos: estudio de abordaje cualitativo, con referencial teórico en el Interaccionismo Simbólico; y metodológico, en la Teoría Fundamentada en los Datos. Fueron 12 participantes que realizaron la cirugía bariátrica en dos servicios de salud (clínica de cirugía bariátrica; hospital general). Recolecta de datos ocurrió entre julio y octubre de 2020, mediante entrevista del tipo intensiva. Las deposiciones grabadas usando dispositivo electrónico y transcritos integralmente. Datos codificados en el software MAXQDA 2020 y analizados basados en el referencial teórico adoptado. Resultados: emergieron dos categorías: Reconstruyendo una vida social; y Redescubriendo la autoestima. De la articulación de esas categorías, construido el fenómeno "Resinificando la vida tras la cirugía bariátrica". Consideraciones Finales: la cirugía bariátrica coadyuvó en cambios significativos en el cotidiano de los participantes, y el Interaccionismo Simbólico permitió la comprensión de como los participantes interpretaron sus significados.

RESUMO Objetivos: compreender os significados atribuídos às mudanças vividas após cirurgia bariátrica por pessoas com obesidade. Métodos: trata-se de estudo de abordagem qualitativa, com referencial teórico no Interacionismo Simbólico; e metodológico, na Teoria Fundamentada nos Dados. Foram 12 participantes que realizaram a cirurgia bariátrica em dois serviços de saúde (clínica de cirurgia bariátrica; hospital geral). A coleta dos dados aconteceu entre julho e outubro de 2020, mediante entrevista do tipo intensiva. Os depoimentos foram gravados usando dispositivo eletrônico e transcritos integralmente. Os dados foram codificados no software MAXQDA 2020 e analisados à luz do referencial teórico adotado. Resultados: emergiram duas categorias: Reconstruindo uma vida social; e Redescobrindo a autoestima. Da articulação dessas categorias, construiu-se o fenômeno "Ressignificando a vida após a cirurgia bariátrica". Considerações Finais: a cirurgia bariátrica coadjuvou em mudanças significativas no cotidiano dos participantes, e o Interacionismo Simbólico permitiu a compreensão de como os participantes interpretaram os seus significados.

People deprived of their freedom: nursing diagnoses in the light of Horta's Theory / Personas privadas de libertad: diagnóstico de enfermería a la luz de la Teoría de Horta / Pessoas privadas de liberdade: diagnóstico de enfermagem à luz da Teoria de Horta

ABSTRACT Objective: to identify the Nursing diagnoses in men deprived of their freedom, based on the Basic Human Needs framework. Methods: a descriptive and exploratory study with a qualitative approach conducted by means of the Theory of Basic Human Needs framework. Data collection took place from June to November 2019, with individual interviews carried out with 220 men deprived of their freedom. The data were submitted to thematic and content analysis directed to NANDA International Taxonomy II. All ethical aspects were respected. Results: 12 Nursing diagnoses belonging to the categories of health problems and potential risks were identified, grouped and interpreted according to the theoretical framework. Sedentary lifestyle, obesity, overweight, risk-prone health behavior, and ineffective health control are factors that have been related to the psychobiological needs. Involvement in recreational activities, anxiety, ineffective coping, risk of violence directed toward others, disrupted family processes, and risk of ineffective relationships were related to the psychosocial needs, while the risk of impaired religiosity was related to the psychospiritual needs. Conclusion: the absence of Nursing diagnoses in the health promotion category signals the need for actions that provide quality of life to these people.

RESUMEN Objetivo: identificar diagnósticos de Enfermería en hombres privados de su libertad, sobre la base del marco referencial de las Necesidades Humanas Básicas. Métodos: estudio exploratorio y descriptivo con enfoque cualitativo realizado de conformidad con el marco referencial de la Teoría de las Necesidades Humanas Básicas. La recolección de datos tuvo lugar entre junio y noviembre de 2019, por medio de entrevistas individuales realizadas con 220 hombres privados de su libertad. Los datos se sometieron a análisis temático y de contenido dirigido a la taxonomía II de NANDA Internacional. Se respetaron todos los aspectos éticos. Resultados: se identificaron 12 diagnósticos de Enfermería pertenecientes a las categorías de problemas de salud y riesgos potenciales, agrupados e interpretados de acuerdo con el referencial teórico. Estilo de vida sedentario, obesidad, sobrepeso, conductas de salud propensas a riesgo y control ineficaz de la salud fueron factores que se relacionaron con las necesidades psicobiológicas. A su vez, menor participación en actividades de recreación, ansiedad, estrategias de enfrentamiento ineficaces, riesgo de violencia hacia otras personas, procesos familiares interrumpidos y riesgo de vinculación ineficaz se mostraron relacionados con las necesidades psicosociales, en tanto que el riesgo de religiosidad perjudicada presentó una relación con las necesidades psicoespirituales. Conclusión: la ausencia de diagnósticos de Enfermería de la categoría de promoción de la salud indica la necesidad de implementar acciones que propicien la calidad de vida de estas personas.

RESUMO Objetivo: identificar os diagnósticos de enfermagem em homens privados de liberdade, com ancoragem no referencial das Necessidades Humanas Básicas. Métodos: estudo exploratório descritivo de abordagem qualitativa conduzido pelo referencial da Teoria das Necessidades Humanas Básicas. A coleta de dados ocorreu nos meses de junho a novembro de 2019, com entrevistas individuais realizadas com 220 homens privados de liberdade. Os dados foram submetidos à análise temática e de conteúdo dirigida à taxonomia II da NANDA Internacional. Todos os aspectos éticos foram respeitados. Resultados: foram identificados 12 diagnósticos de enfermagem pertencentes às categorias de problemas de saúde e riscos potenciais, agrupados e interpretados conforme o referencial teórico. Estilo de vida sedentário, obesidade, sobrepeso, comportamento de saúde propenso a risco e controle ineficaz da saúde são fatores que se relacionaram às necessidades psicobiológicas. Já o envolvimento em atividades de recreação diminuído, ansiedade, enfrentamento ineficaz, risco de violência direcionada a outros, processos familiares interrompidos e risco de relacionamento ineficaz se mostraram relacionados às necessidades psicossociais, ao passo que o risco de religiosidade prejudicada apresentou relação com as necessidades psicoespirituais. Conclusão: a ausência de diagnósticos de enfermagem da categoria de promoção da saúde sinaliza a necessidade de ações que propiciem qualidade de vida a essas pessoas.