Acesso de pessoas deficientes auditivas a serviços de saúde em cidade do Sul do Brasil / Access by hearing-disabled individuals to health services in a southern Brazilian city

Este estudo transversal, de base populacional, tem como objetivo comparar o acesso dos portadores de deficiência auditiva incapacitante a serviços assistenciais e de prevenção com os ouvintes de Canoas, Rio Grande do Sul, Brasil. A amostra incluiu 1.842 pessoas com 15 anos ou mais, sendo a maioria mulheres (52,9 por cento). A renda individual de dois salários mínimos ou mais foi a mais freqüente (42,7 por cento). As pessoas com deficiência auditiva incapacitante tiveram 30 por cento maior probabilidade de ter consultado nos dois meses anteriores à entrevista (RP = 1,3, IC95 por cento: 1,10-1,51) e ter sido internado nos 12 meses anteriores à entrevista (RP = 2,1, IC95 por cento: 1,42-3,14). Nas variáveis relativas à saúde mental, os deficientes auditivos tiveram 1,5 mais probabilidade de terem consultado para problemas de nervos (IC95 por cento: 1,18-1,95) e 4,2 mais probabilidades de terem sido internados em hospital psiquiátrico que os ouvintes (IC95 por cento: 2,17-8,16). Assim como encontrado na literatura, as mulheres deficientes auditivas realizaram menos auto-exame das mamas e exame citopatológico de colo uterino. Os dados encontrados indicam a necessidade de investir em educação em saúde e campanhas específicas para o grupo de pessoas investigado.

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9 percent of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U$360/month (42.7 percent). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95 percentCI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95 percentCI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2 427 persons 4 years old and over. The study population was composed of 1 040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1 percent of the population studied showed some level of hearing impairment, and 6.8 percent (95 percent confidence interval (CI) = 5.5 percent-8.1 percent) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4 percent (95 percent CI = 4.4 percent-6.4 percent); for severe hearing loss, 1.2 percent (95 percent CI = 0.7 percent-1.7 percent); and for profound hearing loss, 0.2 percent (95 percent CI = 0.03 percent-0.33 percent). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95 percent CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95 percent CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95 percent CI = 2.14-7.16); and those with lower income (OR = 1.56; 95 percent CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.

OBJETIVO: Presentar los primeros datos de un estudio de base poblacional sobre sordera y deficiencia auditiva en Brasil. MÉTODOS: Se realizó una encuesta transversal de hogares en 2003 en la que participaron 2 427 personas de 4 años de edad o más. La población de estudio estuvo compuesta por 1 040 hogares escogidos de manera sistemática en 40 sectores censales (conglomerados de viviendas) escogidos al azar en la ciudad de Canoas, estado de Rio Grande do Sul, en el sur de Brasil. Se evaluó la función auditiva de los participantes mediante audiometría tonal liminar y examen físico, según el Protocolo para el Estudio de Trastornos Oticos y Auditivos y las definiciones de niveles auditivos, ambos de la Organización Mundial de la Salud. Entre los datos socioeconómicos colectados estaban los años de escolaridad de las personas estudiadas y los ingresos del jefe del hogar. RESULTADOS: Se encontró que 26,1 por ciento de la población estudiada mostró algún grado de deficiencia auditiva y 6,8 por ciento (intervalo de confianza de 95 por ciento [IC95 por ciento]: 5,5 por ciento a 8,1 por ciento) se clasificó en el grupo con deficiencia auditiva incapacitante. La prevalencia de pérdida auditiva moderada fue de 5,4 por ciento (IC95 por ciento: 4,4 por ciento a 6,4 por ciento); de pérdida auditiva grave, 1,2 por ciento (IC95 por ciento: 0,7 por ciento a 1,7 por ciento); y de pérdida auditiva profunda, 0,2 por ciento (IC95 por ciento: 0,03 por ciento a 0,33 por ciento). Los grupos en mayor riesgo de pérdida auditiva fueron los hombres (razón de posibilidades [odds ratio, OR] = 1,54; IC95 por ciento: 1,06 a 2,23); los participantes de 60 años de edad o más (OR = 12,55; IC95 por ciento: 8,38 a 18,79); los que tenían menos años de escolaridad formal (OR = 3,92; IC95 por ciento: 2,14 a 7,16); y los que tenían menores ingresos (OR = 1,56; IC95 por ciento: 1,06 a 2,27). CONCLUSIONES: Estos resultados respaldan las recomendaciones de los planificadores de...