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Resumo Objetivo Descrever metodologia para o desenvolvimento de tecnologias sociais em enfermagem/saúde centradas no usuário Métodos Estudo de desenvolvimento tecnológico que apresenta proposição metodológica para a expansão de tecnologias sociais, com foco na solução de problemas oriundos de demandas dos usuários de saúde. Resultados A metodologia de aplicação tecnológica foi concebida e sistematizada em cinco fases sequenciais, quais sejam: Diagnóstico situacional, Idealização e prototipagem, Validação, Implementação, Fidelização e impacto social da aplicação. Conclusão Pretende-se, com essa nova proposta de desenvolvimento tecnológico, contribuir para a fidelização e o impacto das tecnologias sociais centradas nas necessidades dos usuários de saúde, a partir de abordagens como o Design Thinking e o Design Centrado no Usuário.
Resumen Objetivo Describir metodología para el desarrollo de tecnologías sociales en enfermería/salud centradas en el usuario Métodos Estudio de desarrollo tecnológico que presenta una proposición metodológica para la expansión de tecnologías sociales, con enfoque en la solución de problemas originarios de demandas de los usuarios de salud. Resultados La metodología de aplicación tecnológica fue formulada y sistematizada en cinco etapas secuenciales, a saber: Diagnóstico situacional, Idealización y creación de prototipo, Validación, Implementación, Fidelización e impacto social de la aplicación. Conclusión Con esta nueva propuesta de desarrollo tecnológico se pretende contribuir para la fidelización y para el impacto de las tecnologías sociales centradas en las necesidades de los usuarios de salud, a partir de intervenciones como el Design Thinking y el Design Centrado en el Usuario.
Abstract Objective To describe the methodology for developing user-centered social technologies in nursing/health Methods A technological development study that presents a methodological proposal for the expansion of social technologies, with a focus on solving problems arising from the demands of healthcare users. Results The technological application methodology was conceived and systematized in five sequential steps, namely: Situational diagnosis, Ideation and prototyping, Validation, Implementation, Reliability, and social impact of the application. Conclusion With this new technological development proposal, we intend to contribute to the reliability and impact of social technologies centered on health users' needs, based on approaches such as Design Thinking and User-Centered Design.
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Resumo Fundamento As doenças oro-valvares têm prevalência mundial expressiva, e a cirurgia de troca valvar melhorou a sobrevida dos pacientes. Objetivos Descrever aspectos clínico-laboratoriais dos pacientes submetidos a implante valvar mecânico e determinar a incidência de trombose de próteses valvares (TPV). Métodos Estudo de coorte retrospectivo com seguimento até nove anos; as variáveis de estudo foram buscadas em prontuários físicos e eletrônicos. Os cálculos foram realizados pelo programa Jamovi 1.2.2.; p<0,05 foi considerado estatisticamente significante. Foram construídas curvas de Kaplan Meier, e realizada análise de regressão de Cox para fatores relacionados à mortalidade. Resultados Foram incluídos 473 pacientes com média de idade de 46,9 ±11,3 anos. A doença reumática foi a principal etiologia. Em média de acompanhamento de 4,43 anos, a mortalidade foi de 16,1%. Pacientes com implantes de próteses na posição aórtica tiveram sobrevida melhor que os portadores em posição mitro-aórtica (p=0,026). Entre os fatores ajustados para mortalidade, apenas classe funcional e insuficiência renal crônica apresentaram significância estatística. A incidência de TPV foi de 0,24/100 pacientes/ano, com primeiro evento após 1000 dias da cirurgia. Tabagismo e pannus foram estatisticamente associados a TPV. Não houve diferenças na variabilidade de INR entre pacientes com e sem trombose por posição protética, mas houve diferença estatística no INR pré-evento trombótico comparado aos que não apresentaram trombose (INR= 2,20[1,80-2,20] vs 2,80[2,20-3,40]; p= 0,040). Identificamos 4,4% de acidentes vasculares cerebrais e 5,2% de sangramentos. Conclusões A população mostrou-se jovem e valvopatia reumática foi frequente. A frequência de TPV foi semelhante à descrita na literatura, apesar da baixa renda e escolaridade da amostra.
Abstract Background Valvular heart diseases are highly prevalent in the world, and surgical valve replacement has improved patients' survival. Objectives To describe clinical and laboratory data of patients undergoing mechanical valve replacement, and to determine the incidence of prosthetic valve thrombosis (PVT). Methods Retrospective cohort study with a follow-up of up to nine years. The study variables were collected from conventional and electronic medical charts. Statistical calculations were performed using the Jamovi software version 1.2.2.; a p<0.05 was considered statistically significant. Kaplan Meier curves were constructed, and Cox regression analysis was performed for analysis of factors related to mortality. Results A total of 473 patients were included, mean age of 46.9 ±11.3 years. Rheumatic disease was the most common etiology. In a mean follow-up period of 4.43 years, mortality rate was 16.1%. Patients with aortic prosthesis showed higher survival than patients with double implant (mitral and aortic) (p=0.026). Of the factors adjusted for mortality, only functional class and chronic renal failure showed statistically significant association. The incidence of PVT was 0.24/100 patients/year, and the first event occurred more than 1000 days after the implant. Smoking and pannus formation were significantly associated with PVT. No differences were found in INR variability between patients with and without thrombosis by prosthetic position, but significant differences were found in INR before thrombosis as compared with patients without thrombosis (INR= 2.20 [1.80-2.20] vs. 2.80 [2.20-3.40]; p= 0.040). The incidence of stroke and bleeding was 4.4% and 5.2% respectively. Conclusions The study population was young, and rheumatic valve disease was common in this group. The prevalence of PVT was similar to that described in the literature, despite the low income and low educational level of our sample.
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ABSTRACT Introduction: Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients. Methods: This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05. Results: Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL. Conclusion: This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.
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Abstract Background Cardiovascular diseases (CVD) accounted for 27% of deaths in Brazil in 2017. Most of the recorded deaths caused by CVD would be preventable if patients controlled risk factors including inadequate diet. The Brazilian Cardioprotective Nutritional Program (Dica Br) adapted the Mediterranean diet pattern to Brazilian typical foods and evaluated the effectiveness of a nutritional program based on cardioprotective foods on cardiovascular events and death of patients with cardiovascular diseases. Objectives To evaluate the effect of Dica Br on the QoL of patients with atherosclerotic disease from two health centers in the city of Rio de Janeiro. Method Randomized clinical trial with 273 participants of both sexes, over 45 years old, followed for four years. The intervention group (IG) received individualized dietary prescription, educational program, individual and group consultations, and phone calls. The control group (CG) received general dietary guidance. The SF-36 was used to assess QoL. The Student's t-test and the Mann-Whitney test was used to compare means between the groups. The mixed model test was used to compare the course of variables over time between the groups. Statistical significance was set at 5%. Result Most patients were male, with an average age of 64.2 ± 8.2 years in the IG and 65±9.5 years in the CG. Most were physically inactive, overweight, and had incomplete elementary school. The most prevalent comorbidity was systemic arterial hypertension, followed by dyslipidemia. QoL improved in both groups at four years. Waist circumference decreased in both groups over time, and low-density lipoprotein cholesterol (LDL-C) levels decreased in the IG but not in the CG after four years of follow-up. Conclusion The cardioprotective diet was effective in reducing LDL-C in the IG, and an improvement in QoL was observed in both intervention and control groups.
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Abstract Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.
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Humans , Coronavirus Infections , Heart Failure , Myocarditis , Betacoronavirus , HospitalizationABSTRACT
OBJECTIVES: Adolescence is characterized by continuing profound mental, physical, and social changes and entering into the labor market during this phase may have negative consequences on physical and mental health. Common mental disorders (CMD) are characterized as disorders of mental functions, including symptoms of depression and anxiety as well as various nonspecific and somatic complaints such as reduced ability to concentrate, tiredness, irritation, and forgetfulness. Despite its increasing prevalence, few studies have addressed CMD and its association with work, in adolescents. In the present study, we aimed to identify the main factors associated with CMD and evaluated its association with work, in school adolescents. METHODS: A cross-sectional study was conducted with 12 to 17-year-old adolescent students using a self-administered questionnaire with questions related to work. CMD was verified using the General Health Questionnaire of 12 items. In total, 3424 adolescents were studied. RESULTS: The prevalence of CMD and work in the last year was 28.72% and 19.63%, respectively. After adjustment for potential confounding variables, multivariate analysis showed associations of CMD with female gender (OR=2.72) and work (OR=1.70). CONCLUSION: In the present study, a high number of cases of CMD were observed among the studied adolescents. Female gender and work history in the last year were negatively and independently associated with the presence of CMD.
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Humans , Female , Child , Adolescent , Mental Disorders/epidemiology , Anxiety Disorders , Schools , Mental Health , Prevalence , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
O aumento da expectativa de vida acarreta, muitas vezes, a prevalência de algumas doenças crônico-degenerativas relacionadas ao envelhecimento, como osteoporose e sarcopenia. Trata-se de pesquisa retrospectiva e prospectiva, com abordagem quantitativa do tipo quase-experimental com pré- e pós-teste, sem grupo-controle, utilizando-se um protocolo de exercícios na fisioterapia aquática. Amostra com 13 mulheres, entre 57 e 84 anos, com diagnóstico médico de osteopenia/osteoporose, comprovado por densitometria óssea. Aplicado protocolo no meio aquático, em 30 semanas, 2 vezes na semana; participantes submetidas a avaliações pré- e pós-intervenção, avaliando-se a força muscular por meio do torque músculo quadríceps com a dinamometria, e a sarcopenia, pelo teste Short Physical Performance Battery (SPPB). Os resultados, após o protocolo de fisioterapia aquática, mostraram que o torque de ambos os lados foi estatisticamente significativo; porém, o lado não dominante (p=0,0059) apresentou maior ganho de força em relação ao membro dominante (p=0,01). Os resultados da sarcopenia também foram estatisticamente significativos após protocolo aquático (p = 0,03458), do que se pode concluir que a fisioterapia aquática se mostra eficaz no torque muscular e sarcopenia.
The increase in life expectancy often leads to the prevalence of some chronic-degenerative diseases related to aging, such as osteoporosis and sarcopenia. This is a retrospective and prospective research, with quantitative approach of the quasi-experimental kind, with pre- and post-test, without control group, using a protocol of exercises in aquatic physiotherapy. Sample with 13 women, between 57 and 84 years old, with a medical diagnosis of osteopenia / osteoporosis, confirmed by bone densitometry. A protocol was applied in aquatic mean, with the duration of 30 week, twice a week. The participants were submitted to pre and post-intervention evaluations, measuring their muscle force through torque of quad muscle with dynamometry, and sarcopenia through Short Physical Performance Battery (SPPB) test. The results, after the aquatic physiotherapy protocol, showed that the torque on both sides was statistically significant; however, the non-dominant side (p = 0.0059) showed greater strength gain compared to the dominant member (p=0.01). The results of sarcopenia were also statistically significant after aquatic protocol (p=0.03458), from which it can be concluded that aquatic physiotherapy is effective in muscle torque and sarcopenia.
El aumento de la esperanza de vida a menudo conduce a la prevalencia de algunas enfermedades crónicas degenerativas relacionadas con el envejecimiento, como la osteoporosis y la sarcopenia. Este es un estudio retrospectivo y prospectivo, con un enfoque cuantitativo cuasi-experimental con prueba previa y posterior, sin un grupo de control, utilizando un protocolo de ejercicio en fisioterapia acuática. Muestra con 13 mujeres, entre 57 y 84 años, con diagnóstico médico de osteopenia / osteoporosis, confirmado por densitometría ósea. Protocolo aplicado en el medio acuático, en 30 semanas, dos veces por semana; Los participantes se sometieron a evaluaciones previas y posteriores a la intervención, evaluando la fuerza muscular utilizando el torque muscular del cuádriceps con dinamometría y sarcopenia, utilizando la prueba de la Batería de rendimiento físico corto (SPPB). Los resultados, después del protocolo de fisioterapia acuática, mostraron que el torque en ambos lados fue estadísticamente significativo; sin embargo, el lado no dominante (p = 0.0059) mostró una mayor ganancia de fuerza en comparación con el miembro dominante (p = 0.01). Los resultados de la sarcopenia también fueron estadísticamente significativos después del protocolo acuático (p=0.03458), a partir del cual se puede concluir que la fisioterapia acuática es efectiva en el torque muscular y la sarcopenia.