Revista Contexto & Saúde

23-31

Authors: Taisa Soares da Silva, Cristina de Santana Farias, Felisberto Farias dos Santos, Irineu Ferreira da Silva Neto, Ana Emília Formiga Marques

Integrative and Complementary Health Practices (Pics) aim to provide a holistic approach, with the aim of promoting health, and providing a good balance between technology, science and humanization. Thus, this article aims to assess the perception of future graduates of the pharmacy course on the role of the pharmacist in Pics. A field research was carried out at a Faculty of Pharmacy in Cariri Cearense. Currently, the college is approved by 10 classes of the pharmacy course. The sample used in the study was composed of students from the ninth and tenth semesters of the Pharmacy course. The results of the study show that 85.3% of academics have knowledge about Pics, however, many are not sure about their knowledge about them. It was possible to observe that students would indicate homeopathy, acupuncture, floral therapy and medicinal plants to treat certain diseases, which may be possible by pharmacists according to specific specifications. Finally, it is considered that the results of this work can contribute by adding values on the evidenced findings, assisting in the discussion of new studies on integrative and complementary practices.

41-53

Authors: Lucélia Hernandes Lima , Carine Raquel Blatt , Marcelo Schenk de Azambuja

Introduction: The monitoring and continuous evaluation of the actions developed in Pharmaceutical Care are strategies for the search for quality, especially in hospitals. A good evaluation aims to reduce uncertainties, improve the effectiveness and monitoring of actions and provide relevant decision-making by assisting in the service management policy. Objective: To develop an evaluation and monitoring matrix for a pharmacy in a hospital. Method: It is an evaluative study. In order to elaborate and validate the content the following steps have been developed: bibliographic review, proposition on dimensions and elaboration of indicators, focus group with experts to validate and prioritize the dimensions and application of the delphi technique to the indicators for relevance and valuation. Cronbach’s alpha coefficient has been used to measure the reliability of the indicators. Results: Five dimensions and 70 indicators have been identified for the evaluation of Hospital Pharmacy, distributed as follows: Care Management (n=15), Human Resources Management (n=13), Drug Management (n=13), Financial Management (n=12) and Patient Clinic Management (n=17). The dimension Drug Management has been prioritized by the specialists for validation and valuation. This dimension resulted in a matrix, with nine indicators. Conclusion: The study has shown the importance of evaluation and monitoring for Hospital Pharmacy management and the capacity of executing consensus methods to quality indicators in high complexity services. The instruments with indicators developed for the dimension Drug Management has shown evidence of validity and good reliability.

68-80

Authors: Karina Schettert Kerschner, Eduarda Batu de Souza, Viviane Cecilia Kessler Nunes Deuschle

Ultraviolet radiation causes cumulative and irreversible skin aggressions and photoprotection remains the most effective way to prevent skin cancer and photoaging. Many beneficial effects attributed to medicinal plants and their bioactive compounds have been the subject of studies. Objective: to develop cosmetic formulations containing the commercial extract of P. granatum, added or not with synthetic organic sunscreen and evaluate the stability and the Sun Protection Factor. Method: the formulations were developed containing 1, 3 and 10 % of the extract of P. granatum, with or without 7 % of octyl methoxinamate, in non-ionic cream, and its physical-chemical stability was evaluated, by determining the organoleptic characteristics, pH and viscosity. Spreadability and SPF in vito were also evaluated. Results: the formulations containing only the extract of P. granatum showed the greatest variations in the stability study and octyl methoxinamate seems to interfere with stability. Conclusion: it is concluded that the formulation containing 10 % of P. granatum extract and 7 % of octyl methoxinamate presented, in addition to adequate stability, an increase in SPF, which would provide a reduction of organic sunscreens in photoprotective formulations. It is recommended that this formulation be kept at room temperature and protected from light, heat and humidity

92-105

Authors: Silvia Pereira , Letícia Bottino, Alexandra Anastacio Monteiro Silva, Daniele Mendonça Ferreira, Daniele Silva Bastos Soares, Patrícia Dias Camacho, Patrícia Henriques, Roseane Moreira Sampaio Barbosa

Carry out a nutritional intervention through the construction and implementation of the Technical Preparation Form focusing on the adequacy of the supply of sodium and lipids in food preparations. Step 1. Diagnosis: Analysis of the amount of lipid using the technique of extraction using the Soxhlet and sodium apparatus by weighing the amount of added salt used and calculating the amount of sodium using the Brazilian Table of Food Composition and application of the script to observe the preparation method. Step 2. Intervention: Development and implementation of the Preparation Technical Sheets using the model recommended by the National School Feeding Program. Step 3. Evaluation of acceptability by students according to the Program manual, analysis of the use of Technical Preparation Sheets by the observation guide and quantity by the method already mentioned above. An adequate lipid value was observed, with sodium, 67.5% above that recommended by the program for two meals (up to 600 milligrams). After the implementation of the technical preparation sheets, the amount of sodium was reduced to 26.4% of the recommendation and that of lipid remained adequate. The intervention was effective in promoting a standardization of the production of rice and beans through the Technical Preparation Form with an adequate amount of oil and added salt, promoting greater nutritional quality

116-129

Authors: Laine de Carvalho Guerra Pessoa Mamede, Rafaela Lira Formiga Cavalcanti de Lima, Alexandre Sérgio Silva, Rubens Batista Benedito, Lydiane de Lima Tavares Toscano, Nadjeanny Ingrid Galdino Gomes, Elisama Araújo de Sena, Maria da Conceição Rodrigues Gonçalves

Hypovitaminosis D is considered a worldwide epidemic with implications that may affect the health of workers. This is a cross-sectional study conducted with 91 workers from Food and Nutrition Units in order to assess the prevalence of hypovitaminosis D and the associations with metabolic parameters. Were evaluated regarding their sociodemographic and occupational profile, exposure to sunlight, anthropometric data and blood pressure. The following exams were performed: 25-hydroxyvitamin D [25(OH)D] and other metabolic parameters. There was a prevalence of 61.54% of the deficiency/insufficiency of 25(OH)D serum levels. No associations were confirmed between the vitamin D status and the sociodemographic and occupational characteristics through the Poisson regression. There was an increased prevalence in patients with diabetes and hypertriglyceridemia. Individuals with high Total Antioxidant Capacity (TAC) values showed a reduction in the prevalence of hypovitaminosis D. In conclusion, a high prevalence of hypovitaminosis D was found among the workers, related to increased blood glucose and triglyceride levels with TAC proving susceptible to reduce this deficiency/insufficiency. The need to monitor laboratory parameters in the health surveillance of workers is stressed.

149-157

Authors: Giovana Secchi da Campo, Nandiny Paula Cavalli, Melissa Medeiros Braz

Pregnancy can be defined as a period of approximately 40 weeks, in which physiological and mechanic adaptations occur, along with strong psychological modifications. Being a moment of vulnerability, it can be negatively influenced by factors such as urinary incontinence, high-risk pregnancy or even a negative body image. Thus, the aim of this study was to compare body image and the occurrence of urinary incontinence in high-risk and usual risk pregnant women. An observational study with a quantitative and cross-sectional approach was conducted to evaluate the occurrence of urinary incontinence and body image of pregnant women. The sample was divided into two groups: high-risk (n=34) and usual risk (n=31) pregnant women. For the data collection, an identification file was applied, collecting data such as obstetric history, followed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and the Body Image Measurement Scale (BIMS). It was observed that both groups were dissatisfied with body image, and urinary incontinence occurrence was moderately above to what is found in literature. No relationship between urinary incontinence and body satisfaction was observed in either group. There was no relationship between urinary incontinence and body image. The pregnant women from both groups presented dissatisfaction regarding body image, and the occurrence of urinary incontinence was slightly higher than that observed in literature.

171-182

Authors: Deise Iop Tavares, Gessica Bordin Viera Schlemmer, Tamires Daros dos Santos, Aline dos Santos Machado, Janine Barbosa da Silva, Melissa Medeiros Braz, Alecsandra Pinheiro Vendrusculo

This study aims to investigate whether there is a correlation between body image, self-esteem, perception of aging, postural balance and handgrip strength in elderly women after practicing Pilates in Water. Descriptive, quasi-experimental study, with a sample composed of sedentary elderly women with preserved cognitive and functional independence. The instruments Body Appreciation Scale, Rosenberg’s Self-Esteem Scale, Aging Perceptions Questionnaire, Timed Up and Go and the manual dynamometer were used. The Pilates in Water protocol was divided into warm-up, strengthening in general and stretching. Statistical analysis was performed using Pearson’s correlation coefficient and Spearman’s correlation test, and the intensity was classified by Malina’s criterion. 33 elderly women (71.5 ± 5.48 years old), overweight (27.02 ± 4.42) and good body image, self-esteem and perception of aging participated in this study. They also had a low risk of falls and low handgrip strength. A moderate correlation between body image and perception of aging was observed after the Pilates in Water exercises protocol with regard to positive beliefs about how to deal with aging. Still, a high correlation was observed between postural balance and handgrip strength. It is concluded that these data are important because means must be directed to provide healthy aging and quality of life for the elderly

198-208

Authors: Melissa Medeiros Braz, Emiláini Sacerdote Rister

Women with negative genital self-image may experience sexual dysfunction. Still, it can be related to discomfort in the pelvic floor. The aim of this study is to investigate the relationship between genital self-image, sexual function and discomfort in the pelvic floor in young university women. This is an observational and cross-sectional study with 102 undergraduate and graduate students, from a total of 135 participants, between 18 and 29 years old, sexually active. An identification form relating to personal data, anamnesis, complaints and sexual activity, the Female Sexual Function Index (FSFI), Pelvic Floor Distress Inventory (PFDI-SF-20) and Female Genital Self-Image Scale (FGSIS) questionnaires were applied. The total FGSIS score indicated positive genital self-image, FSFI good sexual function and PFDI-20 discomfort in the low pelvic floor. There was a positive relationship between genital self-image and sexual function and an inverse relationship with discomfort in the pelvic floor. Women had positive genital self-image, good sexual function and low discomfort in the pelvic floor, and the variables were related to each other.

221-235

Authors: Mariana Lectícia Beraldi, Fernanda de Freitas Mendonça, Sarah Beatriz Coceiro Meirelles Félix

The Permanent Health Education (PHE) is a strategy that searches to transform the practice and organization of the work process from the demand of its own work. A exploratory, descriptive, qualitative research, case study type, that aimed to unveil the arrangements built by the health team that allowed the work management during the qualification program of the Primary Health Care. The data was collected in the period of July 2018 to April 2019 through observation-participant study tool and semi structed interviews with workers of a Family Health Care Unit in a city of Paraná. The results showed many arrangements developed by the work team: general and staff meetings, joint effort for risk stratification and setting-up groups for the users. The protagonism of the workers enabled the program to be a space for PHE. It is concluded that the seal drove the team to develop and work in cooperation. The PHE developed by the staff gave the opportunity to minimize the logics of the vertical process catch and give quality to its arrangements.

253-264

Authors: Premma Hary Mendes Silva, Jackson Ronie Sá Silva

Leprosy is a serious public health problem that historically affects populations living in poor living conditions. In Brazil, leprosy is a disease that affects the poorest sections of the population. Although it is a disease that, once treated, presents significant possibilities of cure and does not present a risk of contagion; due to cultural prejudice, a situation of stigma in relation to the disease still persists. When recognized as hansenian, the individual is permeated by a set of degrading designations. Thus, we recognize prevention through Health Education as a noble aspect in leprosy control, and one of the forms used is information through educational materials. With this investigation we intend to understand the discourses on the prevention of leprosy conveyed on posters, booklets, pamphlets and guidance guides aimed at health professionals and patients, distributed in health posts and units in the municipality of São Luís, Maranhão. For this, theoretical-methodological strategies of documentary research were used in the investigation. The documents analyzed gave evidence that in the dissemination of information on leprosy prevention, what prevails is the biomedical discourse on diagnosis, treatment and cure. The sociocultural aspects of the disease with regard to prejudice are absent or are approached timidly in the documents. Moreover, sociocultural information, such as alerting to aspects of prejudice, is not perceived. Language is clearly clinical-biomedical and there is a concern to disseminate among health professionals and patients only that leprosy has a cure.

279-289

Authors: Bruna da Silva Rodrigues, Juliedy Waldow Kupske, Renan Felipe Rasia, Thais Severo Dutra, Moane Marchesan Krug, Paulo Ricardo Moreira, Kalina Durigon Keller, Rodrigo de Rosso Krug

The aim of the study was to analyze the effects of physical exercise on physical fitness and quality of life of patients with chronic renal failure undergoing hemodialysis. This is an intervention study, with a sample of 13 patients on hemodialysis at the Renal Clinic of Hospital São Vicente de Paulo. The program was applied in 2019/2 (August to December) and took place during the first two hours of hemodialysis (intradialitic), three times a week lasting 20/70 minutes. The same consisted of active stretching, warm-up, cycle ergometer training, resistance training and stretching. Participants in the physical exercise program showed improvement in all physical valences evaluated, occurring significantly in upper limb resistance (pre-test = 17.85 ± 4.54; post-test = 20.69 ± 7.62; p = 0.034) and handgrip strength (pre-test = 28.15 ± 9.39; post-test = 28.62 ± 12.61; p = 0.048), as well as a significant improvement in quality of life in pain domain (pre-test = 73.15 ± 26.92; post-test = 91.46 ± 18.78; p = 0.016), vitality (pre-test = 78.00 ± 15.48; post-test = 90.08 ± 9.03; p = 0.010) and social aspects (pre-test = 71.31 ± 28.63; post-test = 85.92 ± 22.42; p = 0.050). We conclude that the resistance exercise program has several benefits for patients on Hemodialysis.

299-309

Authors: Jessica Cristina Costa Barbosa, Alessandra Esquivel Sales, Nora Manoukian Forones, Edvane Birelo Lopes De Domenico

The objective was to identify the quality of life of patients with gastrointestinal cancer and chronic pain and to correlate the quality of life with sociodemographic, clinical, therapeutic and pain gradation data. This is a cross-sectional, quantitative study, in which patients with gastrointestinal cancer and chronic pain attended at the gastroenterology clinic of a general hospital in the city of São Paulo participated. A sociodemographic and clinical questionnaire, the EORTC-QLQC30 instrument and the Brief Pain Inventory (BPI) were used. Data analysis: descriptive and analytical, correlating the variables with the QoL domains. Thirteen patients participated in the study, mostly male, married, economic classification C2 (61.5%). All were in pain at the time of data collection, with a mean of 2.54 (SD=2.88) by BPI and with the worst score reported in the last 24 hours at 8.15 (SD=2.03). The main changes in QoL evidenced were, in addition to pain: fatigue, insomnia and loss of appetite, and the more advanced the disease, the worse the symptoms and the functional impairment. The data showed that patients live with pain of moderate intensity and, if worse clinical condition, greater intensity. Pain compromises the quality of life of these patients in multiple aspects, showing that measures need to be taken to favor pain control, from the drug therapy regimen to educational and care activities

322-331

Authors: Ingrid Bergmam do Nascimento Silva, Milenna Azevedo Minhaqui Ferreira, Anna Cláudia Freire de Araújo Patrício, Brenda Feitosa Lopes Rodrigues, Maria Hellena Ferreira Brasil, João Agnaldo Nascimento, Richardson Augusto Rosendo da Silva

Objective: To analyze the presence of depression and anxiety of people living with HIV, as well as the association of depression on anxiety. Method: Cross-sectional, quantitative study, conducted between january and july of the year 2019. The participants were 100 people living with HIV who received outpatient care at a Hospital for infectious diseases, northeast, Brazil. A socio-demographic questionnaire, Hamilton Depression Scale and Beck anxiety scale were used. There was descriptive and inferential statistical analysis with KRUSKL Wallis tests and T test, considering significant when p ≤ 0.05. Results: It was identified that 64% were men, 70% heterosexual, 50% had between 20 and 30 years and 90% contracted HIV by sexual contact, 42% had depression and 52% had minimal anxiety. The influence of depression on anxiety (p = 0,041) was evidenced, as well as an association between depression and anxiety scores (p = 0.001). Conclusion: The hypothesis that depression influences the anxiety of people with HIV was confirmed.

345-361

Authors: Marcela Milrea Araújo Barros, Ivone Evangelista Cabral

Objective: To analyze scientific publications regarding the trend in the literature on the relationship between air pollution and respiratory disorders in early childhood. Method: This is a narrative review of original articles and systematic reviews in English, Portuguese, French and Spanish, available in Lilacs, PubMed/Medline, Scopus, EBSCO/CINAHL, EVIP-NET and Cochrane Library databases. In the search, descriptors were combined in trio with Boolean operators and/or in November 2019, without a definition of time frame. Results: Of the 1,702 results, 42 publications between the years 1993-2019 were included. After eliminating duplicates, peer reviewers performed the analysis by grouping them into three decades (1990, 2000, 2010). The centrality of the epidemiological model in the concepts related to the respiratory condition, the environment and the child’s vulnerability stands out as a trend. However, the cause-and-effect relationships disregarded the structural determinants of society, critical of the child’s health and the air pollutants that influenced hospitalizations. Therefore, they determined hospitalizations for respiratory conditions due to causes sensitive to primary care. Conclusion: Promoting healthy environments and reducing preventable deaths requires looking beyond the clinical-epidemiological model. Facing this problem requires rethinking the way to produce knowledge articulating health and environment.

375-384

Authors: Ana Cláudia de Carvalho Fernandes, Thuane Sales Gonçalves, Hágabo Mathyell Silva, Carina de Morais Neves, Isabela Viana Oliveira, Djenane Ramalho de Oliveira, Adriana Maria Kakehasi, Maria Raquel Costa Pinto, Mariana Martins Gonzaga do Nascimento

Rheumatoid arthritis (RA) is a inflammatory, chronic disease, which can bring several consequences to the individual. Patients with RA can present several comorbidities that may influence the clinical evolution of RA. Objective: evaluate the association between comorbidities and the RA activity profile among patients attending a rheumatology clinic of a public university hospital. Methods: this is a cross-sectional study, which collected demographic, diseases, lifestyle habits and RA profile data from a representative sample of patients with RA attending the outpatient clinic. A descriptive analysis of these data was performed, as well as univariate and multivariate analyzes to evaluate factors associated with the DAS28 (Disease Activity Score 28). Results: two hundred and one patients were included, a female majority (85.6%; n = 172) was detected and the mean age was 60.3 ± 11.5. Seven patients (3.5%) were obese, 17 (8.5%) smokers, 106 (52.7%) hypertensive, 38 (18.9%) diabetic and 72 (35.8%) had dyslipidemia. A mean functional comorbidity index of 2.3 ± 1.19 and a mean of 4.2±2,2 diseases per patient were identified. Age equal or greater than 60 years (OR = 0.40, 95% CI 0.21-0.74) and be diabetic (OR = 2.96, 95% CI, 30-6,74) were statistically significantly associated with moderate or high DAS28. Conclusion: the presence of comorbidities was frequent among patients with RA. Furthermore, age equal to or greater than 60 years was negatively associated, and a diagnosis of diabetes mellitus (DM) positively associated with moderate to high disease activity according. The findings reinforce the need for DM monitoring among these patients, especially the younger ones.

396-408

Authors: Gracielle Pampolim, Alessandra Miranda Ferres, Isabelle Gadiolli Verzola, Glenda Pereira Lima Oliveira

The aim of the this study was to verify the prevalence and associated factors with negative self-perceived health in the elderly population assisted by primary health care in a community in Vitória – Espírito Santo. An observational, cross-sectional analytical study was carried out with 241 elderly people from a community in Vitória, Espírito Santo. Self-perceived health was the outcome variable, and sociodemographic characteristics, lifestyle and health characteristics were the exposure variables. Data were analyzed using Pearson’s Chi-Square test and the Prevalence Ratio was calculated for variables significantly associated with the outcome (p <0.05). The prevalence of negative self-perceived health was 46.5%, and the factors associated with the outcome were: white race, polypharmacy, incapacity for daily activities, depressive symptoms, risk of falls and negative perception of quality of life. The findings of this study can assist in the management of care provided to the elderly, aiming at maintaining and recovering the independence, autonomy and health of the elderly, and thus contribute to a better quality of life for this population.