Survey on the employment intention in primary healthcare unit of medical undergraduates and analysis of corresponding learning and psychological influencing factors / 中华医学教育探索杂志

Objective:To investigate the relationship between medical students' employment intention in primary healthcare unit and their learning and psychological state through a questionnaire survey among clinical undergraduates.Methods:A cross-sectional survey was conducted among 821 graduates of a Medical University in 2017 to investigate their employment intention, learning and psychological status and employment plan. The learning and psychological status was evaluated by a self-designed questionnaire. Independent-sample t test, variance analysis and multiple linear regression analysis were used to examine the relevant factors affecting medical students' employment intention in primary healthcare by SPSS 21.0 version. Results:A total of 810 questionnaires were distributed and 753 questionnaires were included in the analysis. The employment intention of working in primary healthcare units of medical students was (4.61±2.24). Students in the advanced class had lower willingness to work in primary healthcare unit (the group of students with higher entrance examination scores) ( P<0.05), and students with higher learning pressure and greater pressure of doctor-patient relationship were more reluctant to work in primary healthcare units ( P<0.05). In terms of the employment plan, students who focus on their professional counterparts are more willing to work in primary healthcare unit, while those who pay more attention to salary are less willing to work in primary healthcare unit ( P<0.05). Conclusion:Improving the incentive policies for working in primary healthcare unit, actively relieving psychological pressure of medical students, and increasing the training of doctor-patient communication can have a positive effect on improving the willingness of medical students to have an employment intention in primary healthcare unit.

Prevalência e fatores associados ao risco de quedas em idosos adscritos a uma Unidade Básica de Saúde do município de Natal, RN, Brasil / Prevalence and factors associated with the risk of falls among the elderly registered in a primary healthcare unit of the city of Natal in the state of Rio Grande do Norte, Brazil

Resumo O objetivo deste artigo foi analisar a prevalência e os fatores associados a quedas em idosos adscritos a uma Unidade Básica de Saúde (UBS), no município de Natal/RN. Estudo transversal realizado com 280 idosos cujos dados foram coletados nas dependências da UBS. A associação entre os desfechos “queda” e “queda recorrente” e as variáveis independentes foi verificada mediante análise bivariada e regressão de Poisson, com cálculo das respectivas razões de prevalências. Prevaleceram os idosos do gênero feminino (68,2%), com média de idade de 71,6 anos (± 6,7), alfabetizados (54,6%), não aposentados (73,5%) e sedentários (87,1%). Registraram queda 53,6% dos idosos, porém 27,8% caíram duas ou mais vezes. O modelo preditivo de queda incluiu o gênero feminino (RP = 1,81), presença de doenças osteoarticulares (RP = 1,71) e comprometimento do equilíbrio (RP = 0,88), enquanto a mobilidade funcional (RP = 0,94), medo de cair (RP = 1,21) e déficit de equilíbrio (RP = 0,80) compuseram o modelo final de quedas recorrentes. Encontrou-se maior prevalência de episódio único de queda e os fatores associados incluíram variáveis sociodemográficas, de saúde e performance física. Por outro lado, associaram-se a ocorrência de duas ou mais quedas apenas as variáveis de performance física.

Abstract The scope of the study was to analyze the prevalence and factors associated with falls among the elderly registered in a Primary Healthcare Unit (PHU) in Natal, State of Rio Grande do Norte. It involved a cross-sectional study conducted with 280 elderly individuals with data collected at the primary healthcare unit. The association between falls, recurrent falls and independent variables was assessed using bivariate analysis and Poisson regression with calculation of their respective prevalence ratios. It involved predominantly elderly females (68.2%) with mean age of 71.6 years (± 6.7), literate (54.6%), non-retired (73.5%) and sedentary (87.1%). 53.6% of the elderly recorded falls and 27.8% fell twice or more. The predictive model of falls included the female gender (PR= 1.81), osteoarticular diseases (PR = 1.71) and balance impairment (PR = 0.88), while functional mobility (PR = 0.94), fear of falling (PR = 1.21) and balance deficit disorders (PR = 0.80) constituted the definitive model of recurrent falls. A higher prevalence of single fall episodes was found and the associated factors included sociodemographic, health and physical performance variables. On the other hand, the occurrence of two or more falls were only associated with physical performance variables.

Realidade sociopolítica, ambiental e de saúde de famílias pertencentes a uma comunidade vulnerável / The social-political-environmental and health reality of families belonging to a vulnerable community

OBJETIVO: Conhecer a percepção de lideranças, profissionais de saúde e usuários acerca da cidadania e melhoria das condições de saúde de famílias pertencentes a uma comunidade vulnerável. MÉTODO: Estudo exploratório, de caráter qualitativo, orientado pela teoria fundamentada nos dados. Os dados foram coletados entre julho e dezembro de 2009, mediante entrevistas com quatro lideranças comunitárias de saúde, oito profissionais de uma equipe de saúde da família e doze usuários da saúde. RESULTADOS: A codificação dos dados resultou nas categorias: Compreendendo as Condições sociais, as Condições políticas, as Condições ambientais e as Condições de saúde de famílias de uma comunidade vulnerável. CONCLUSÕES: Se por um lado as políticas de seguridade social e de saúde possibilitaram a redução da pobreza e das desigualdades locais, por outro lado, não garantem a necessária expansão da cidadania e nem mesmo a melhoria das condições de saúde.

The scope of this paper is to ascertain the perception of community leadership, health professionals and users regarding citizenship status and the enhancement of the healthcare conditions of families belonging to a vulnerable community. This is an exploratory study of a qualitative nature, guided by theory based on data. Data were collected between July and December 2009, by means of interviews with four community health leaders, a team of eight family health team professionals and twelve health users. The codification of the data resulted in the following categories: Understanding the social conditions, the political conditions, the environmental conditions and the health conditions of families in a vulnerable community. The conclusions reached were, that if on the one hand the social security and health policies made it possible to reduce poverty and local inequalities, on the other hand they do not ensure the requisite enhancement of citizenship or even the improvement of health conditions.