Experience and associated factors of sexuality education among kindergarten and primary and secondary school teachers / 中国学校卫生

Objective@#To investigate the experience, attitude and practice of sexuality education for teachers, so as to provide evidence for promoting sexuality education training for teachers and teaching ability improvement.@*Methods@#From September to October 2021, 2 146 valid data of kindergarten and primary and secondary school teachers across the country were collected. Associateds factors of teachers sexuality education behavior were explored by Logistic regression analysis.@*Results@#Family and school based sexuality education experiences were insufficient among teachers (22.51%, 46.55%), and the proportions of female teachers who had received sexuality education (20.44%, 41.67%) were significantly higher than that of male teachers (2.05%, 4.90%). Currently, 47.53 % of the kindergartens and primary and secondary schools from participating teachers didn t carry out sex education, which mainly focused in the field of reproductive health and physical development. Kindergartens and primary and secondary schools often integrated sex education into other disciplines (64.48%, 47.83%). Teachers acceptance of family and school based sexuality education, students willingness to communicate on sexual topics with teachers, teachers confidence in answering sexual questions were positively correlated with teachers teaching activities of sexuality education ( OR=1.59, 1.37, 1.67, 1.67, P < 0.01 ).@*Conclusions@#Teachers teaching ability of sexuality education is insufficient, and school based sexuality education couldn t meet students developmental needs. Providing sexuality education training to teachers and enhancing their confidence in answering sexual questions are helpful to facilitate sexuality education teaching activities.

Development of Index System for Assessing Parent s Ability on Child Injury Prevention by Delphi consultation / 中国学校卫生

Objective@#To construct and determine the weight of Index System for Assessing Parent s Ability on Child Injury Prevention, and to provide the basis for childhood injury intervention in family.@*Methods@#Twenty four experts majored in related fields were invited to participate in Delphi consultation. The final index system was constructed according to the consulting results and the weight of primary and secondary indicators were calculated.@*Results@#The final index system consisted of 5 subscales corresponding to 5 age groups: 0,1-2,3-5,6-11 and 12-17 years old. Each scale included 4 primary indicators and 11 secondary indicators. The weight of primary indicators obtained by analytic hierarchy process is 0.28 for "environment", 0.16 for "product", 0.31 for "behaviors and skills", and 0.25 for "psychology". The highest weight of secondary indicators for "environment", "product" and "behaviors and skills" was "water area", while the top secondary indicators for "psychology" included "parental style""emotional control" "family atmosphere", with all indicators weighted higher than 0.2.@*Conclusion@#The Index System for Assessing Parent s Ability on Child Injury Prevention by Delphi consultation is comprehensive in content, and with the focus on parental behaviors and skills on injury prevention.

Saúde mental dos profissionais da saúde na pandemia do coronavírus (Covid-19) / Mental health of health care professionals in the coronavirus pandemic (Covid-19)

Introdução: A pandemia do coronavírus (Covid-19) impôs desafios adicionais aos profissionais da saúde (PS), potencializando o risco de sofrimento psíquico. Objetivo: Avaliar o perfil sociodemográfico e a saúde mental de uma amostra de PS do Brasil durante a pandemia do Covid-19. Métodos: Estudo transversal online realizado durante 1 mês, entre maio e junho de 2020. Sintomas depressivos foram avaliados pelo Patient Health Questionnaire 9 (PHQ-9) e o nível de burnout pelo Copenhagen Burnout Inventory (CBI). Resultados: 1054 PS foram incluídos, sendo 34,5% médicos, 19,1% técnicos de enfermagem, 14,2% enfermeiros e 11,9% psicólogos. Mais da metade da amostra total apresentou escores ≥ 50 no domínio de burnout pessoal (PB) da CBI, indicativo de alto nível de burnout, e escores no PHQ-9 sugestivos de depressão clinicamente significativa, sendo estes índices mais elevados entre os técnicos de enfermagem (68,2% com PB ≥ 50 e 68,7% com PHQ-9 ≥ 9) e os PS da linha de frente (61,3% com PB ≥ 50 e 58% com PHQ-9 ≥ 9). Os técnicos de enfermagem apresentaram escores PB (58,4 ± 20,9) e do domínio de burnout relacionado ao trabalho (WB = 51,0 ± 21,1) superiores aos dos médicos (PB= 48,2 ± 19,9 e WB= 44,2 ± 19,1) e dos psicólogos (PB= 44,2 ± 17,4 e WB= 41,2 ± 16,7) p < 0,001. Conclusão: Os elevados níveis de burnout e depressão, mais preocupantes entre os técnicos de enfermagem, corroboram a vulnerabilidade dos PS ao sofrimento emocional no contexto do atendimento à Covid-19, demonstrando a urgência de intervenções específicas.(AU)

Introduction: The coronavirus pandemic (Covid-19) posed additional challenges to health care professionals (PS), increasing the risk of psychological distress. Objective: To evaluate the sociodemographic profile and mental health of a sample of PS in Brazil during the Covid-19 pandemic. Methods: Cross-sectional online study conducted during 1 month, between May and June 2020. Depressive symptoms were assessed by the Patient Health Questionnaire 9 (PHQ-9) and the level of burnout by the Copenhagen Burnout Inventory (CBI). Results: 1054 PS were included, being 34.5% physicians, 19.1% nursing technicians, 14.2% nurses and 11.9% psychologists. More than half of the total sample had scores ≥ 50 in the the personal burnout (PB) domain of CBI, indicative of a high level of burnout, and PHQ-9 scores suggestive of clinically significant depression, these rates being higher among nursing technicians (68.2% with BP ≥ 50 and 68.7% with PHQ-9 ≥ 9) and frontline PS (61.3% with BP ≥ 50 and 58% with PHQ-9 ≥ 9). Nursing technicians had PB scores (58.4 ± 20.9) and work-related burnout domain scores (WB = 51.0 ± 21.1) higher than those of physicians (PB = 48.2 ± 19.9 and WB = 44.2 ± 19.1) and psychologists (PB = 44.2 ± 17.4 and WB = 41.2 ± 16.7) p <0.001. Conclusion: The high levels of burnout and depression, most worrying among nursing technicians, corroborate the vulnerability of the PS to emotional suffering in the context of the Covid-19 pandemic. Specific interventions are urgent.(AU)

Introducción: La pandemia de coronavirus (Covid-19) planteó desafíos adicionales a los profesionales de la salud (PS), aumentando el riesgo de angustia psicológica. Objetivo: Evaluar el perfil sociodemográfico y la salud mental de una muestra de PS en Brasil durante la pandemia Covid-19. Métodos: Estudio transversal en línea realizado durante 1 mes, entre mayo y junio de 2020. Los síntomas depresivos fueron evaluados por el Patient Health Questionnaire 9 (PHQ-9) y el nivel de burnout por el Copenhagen Burnout Inventory (CBI). Resultados: Se incluyeron 1054 PS, siendo 34,5% médicos, 19,1% técnicos de enfermería, 14,2% enfermeras y 11,9% psicólogos. Más de la mitad de la muestra total tuvo puntajes ≥ 50 en el dominio de Burnout personal (PB) de CBI, indicativo de un alto nivel de Burnout, y puntajes PHQ-9 sugestivos de depresión clínicamente significativa, siendo estas tasas más altas entre los técnicos de enfermería (68,2% con PB ≥ 50 y 68,7% con PHQ-9 ≥ 9) y el PS de primera línea (61,3% con PB ≥ 50 y 58% con PHQ-9 ≥ 9). Los técnicos de enfermería tuvieron puntuaciones de PB (58,4 ± 20,9) y el dominio de burnout laboral (WB = 51,0 ± 21,1) superior al de los médicos (PB = 48,2 ± 19,9 y WB = 44,2 ± 19,1) y psicólogos (PB = 44,2 ± 17,4 y WB = 41,2 ± 16,7) p <0,001. Conclusión: Los altos niveles de burnout y depresión, que son más preocupantes entre los técnicos de enfermería, corroboran la vulnerabilidad del PS al sufrimiento emocional en el contexto de la atención al Covid-19, demostrando la urgencia de intervenciones específicas.(AU)

Development of core recommendations on physical activity for Chinese students aged 7-18 years based on Delphi method and analytic hierarchy process / 中国学校卫生

Objective@#To construct core information about physical activities of Chinese students aged 7-18 years, so as to provide a reference for impoving the level of adolescents physical activities.@*Methods@#Canadian 24 Hour Movement Guidelines for Children and Youth was used as a framework, the preliminary core recommendations on physical activity for Chinese students aged 7-18 years were developed based on qualitative research. Recommendations covered three scales, including physical activity, sedentary behaviour and sleep. Physical activity included four subscales of frequency, intensity, duration and type, while sedentary behaviour and sleep only included one subscale. Three rounds of consultation were conducted using Delphi method. In the second round of consultation, the results of 2014 Chinese National Surveys on Students Constitution and Health were presented to experts for reference. In the third round of consultation, experts need to rank the importance of seven items of physical fitness under the physical activity type subscale by age group through analytic hierarchy process.@*Results@#Totally 25, 25, and 18 experts were consulted in three rounds respectively. The questionnaire response rates in 3 rounds were 100.0%, 100.0%, and 94.4%, respectively. The authority coefficients were 0.92, 0.93, and 0.91. The harmony coefficients were 0.63( χ 2=237.10, P <0.01), 0.63( χ 2= 242.60 , P <0.01), and 0.76( χ 2=97.05, P <0.01). It was recommended that students aged 7 to 18 years in China should do moderate to vigorous physical activity for a cumulative total of at least 60 minutes per day, and most of the 60 minutes or more per day should be either moderate or vigorous intensity aerobic physical activity. Of the daily physical activity, students should conduct vigorous intensity aerobic physical activity, muscle strengthening and bone strengthening physical activity on at least 3 days a week. At least 2 hours of daytime outdoor activity was recommended for primary school students and 1 hour for secondary school students. 7-12 year old students should do more physical activities that enhance flexibility, coordination and agility, while 13-18 year old students should do more physical activities that enhance strength, endurance and speed. Sedentary behaviour included one subscale, where students should reduce sedentary behaviour, break up long periods of sitting as often as possible, and limit recreational screen time and online study time. Sleep included one subscale of duration.Students should get sufficient and uninterrupted sleep per night.@*Conclusion@#The development of core recommendations on physical activity for Chinese students aged 7 to 18 might help improve physical activity levels and promote health of children and adolescents.

Risks of occupational illnesses among health workers providing care to patients with COVID-19: an integrative review / Riscos de adoecimento ocupacional em profissionais da saúde que atendem pacientes com COVID-19: revisão integrativa / Riesgos de enfermedad ocupacional en profesionales de la salud que atienden pacientes con COVID-19: revisión integradora

Objective: to analyze evidence concerning the risks of occupational illnesses to which health workers providing care to patients infected with COVID-19 are exposed. Method: integrative literature review conducted in the following online databases: Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science (WoS), Excerpta Medica Data-Base (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus (Elsevier). Original articles published between November 2019 and June 2020, regardless of the language written, were included. A descriptive analysis according to two categories is presented. Results: the sample is composed of 19 scientific papers. Most were cross-sectional studies with an evidence level 2C (n=17, 90%) written in English (n=16, 84%). The primary thematic axes were risk of contamination and risk of psycho-emotional illness arising from the delivery of care to patients infected with COVID-19. Conclusion: the review presents the potential effects of providing care to patients with COVID-19 on the health of workers. It also reveals the importance of interventions focused on the most prevalent occupational risks during the pandemic. The studies' level of evidence suggests a need for studies with more robust designs.

Objetivo: analisar as evidências sobre os riscos de adoecimento ocupacional aos quais estão expostos os profissionais de saúde que cuidam de pacientes acometidos pela COVID-19. Método: revisão integrativa da literatura realizada por meio de busca on-line nas bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science (WoS), Excerpta Medica Data-base (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Scopus (Elsevier). Incluíram-se artigos originais, publicados entre novembro de 2019 e junho de 2020, sem restrições de idioma. A análise descritiva dos resultados é apresentada em duas categorias. Resultados: a amostra constituiu-se de 19 produções científicas com predomínio da língua inglesa (n=16, 84%) e estudos de corte transversal, com nível de evidência 2C (n=17, 90%). Os estudos mostraram, como principais eixos temáticos, o risco de contaminação e o risco de adoecimento psicoemocional no atendimento a pacientes acometidos pela COVID-19. Conclusão: a revisão mostrou os potenciais efeitos sobre a saúde dos profissionais durante o atendimento de pacientes acometidos pela COVID-19. Evidenciou-se a importância da implementação de estratégias de intervenção focadas nos riscos ocupacionais mais prevalentes durante a pandemia. O nível de evidência dos estudos sugere a necessidade de desenvolvimento de pesquisas com delineamentos mais robustos.

Objetivo: analizar las evidencias sobre los riesgos de enfermedad ocupacional a los cuales están expuestos los profesionales de la salud que cuidan de pacientes afectados por la COVID-19. Método: revisión integradora de la literatura realizada a través de búsqueda online en las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science (WoS), Excerpta Medica Data-base (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Scopus (Elsevier). Fueron incluidos artículos originales, publicados entre noviembre de 2019 y junio de 2020, sin restricciones de idioma. El análisis descriptivo de los resultados se presenta en dos categorías. Resultados: la muestra fue constituida por 19 producciones científicas con predominio del idioma inglés (n=16, 84%) y estudios de corte transversal con nivel de evidencia 2C (n=17, 90%). Los estudios mostraron como principales ejes temáticos el riesgo de contaminación y riesgo de enfermedad psicoemocional, en la atención a pacientes afectados por COVID-19. Conclusión: la revisión mostró los potenciales efectos sobre la salud de los profesionales durante la atención de pacientes afectados por COVID-19. Se evidenció la importancia de implementar estrategias de intervención, enfocadas en los riesgos ocupacionales más prevalentes durante la pandemia. El nivel de evidencia de los estudios sugiere la necesidad de desarrollar investigaciones con delineamientos más robustos.

Training practice of nutrition health educators in Japan / 中国学校卫生

Abstract@#The editorial aims to provide information about the development of nutritional educator system, as well as training, position statement, current status and program implementation of nutritional educators in Japan, through review on research literature, statistics from government reports and work summaries from nutritional educators. The current article proposes a developmental framework as a roadmap for future practice to enhance the value and utility of nutritional.

Distúrbios osteomusculares relacionados ao trabalho autorreferidos por profissionais de saúde de um hospital em Portugal / Self-reported work-related musculoskeletal disorders among health professionals at a hospital in Portugal

Introdução: Os distúrbios osteomusculares relacionados com o trabalho (DORT) são responsáveis pela morbidade de muitos profissionais de saúde. Objetivo: Realizar um diagnóstico da prevalência de DORT autorreferidos por profissionais de saúde. Métodos: Foi realizado um estudo, descritivo e exploratório, envolvendo profissionais de saúde de uma instituição hospitalar no norte de Portugal. Os dados foram coletados ao longo do mês de dezembro de 2017, mediante aplicação de questionário eletrônico à população total (n=435). Foram utilizados instrumentos de caracterização sociodemográfica, percepção de conhecimentos sobre ergonomia e mobilização manual de cargas, avaliação da percepção de carga (Escala de Percepção de Carga de Manuseio do Paciente ­ EPCMP) e sintomas osteomusculares autorreferidos (Questionário Nórdico de Sintomas Osteomusculares ­ QNSO). Resultados: A amostra foi constituída de 105 profissionais, essencialmente enfermeiros e assistentes operacionais, apresentando uma ocorrência elevada de sintomas em diversas regiões corporais, maioritariamente na coluna vertebral. Conclusões: DORT em profissionais de saúde devem ser considerados um problema nas instituições de saúde que carecem de intervenções além dos tradicionais programas formativos, especialmente programas multifatoriais de natureza sistémica

Background: Work-related musculoskeletal disorders (WMSDs) are responsible for morbidity among many health professionals. Objective: To establish the prevalence of self-reported WMSDs among health professionals. Methods: Descriptive and exploratory study with health professionals at a hospital in northern Portugal. Data were collected in December 2017 by means of an electronic questionnaire applied to the total target population (n=435). We applied instruments for sociodemographic characterization, perception of knowledge on ergonomics and manual mobilization of loads, the Patient Handling Burden Scale (PHBS) and the Nordic Musculoskeletal Questionnaire (NMQ) for self-reporting musculoskeletal symptoms. Results: The sample comprised 105 professionals, mainly nurses and nursing assistants, who exhibited high frequency of symptoms in several body areas, mainly the spine. Conclusions: WMSDs involving health professionals should be considered a problem for health institutions which do not implement interventions beyond traditional training programs, especially multifactorial programs of systemic nature

Visita domiciliaria: un espacio para la adquisición y modificación de prácticas en salud / Home visit: a place for the acquisition and modification of health practices / Visita domiciliar: um espaço para a aquisição e modificação de práticas de saúde

Resumen La visita domiciliaria realizada por el asistente técnico de atención primaria en salud (ATAPS), corresponde a la principal actividad fundamental de atención primaria desarrollada en Costa Rica, cuya principal labor es proporcionar información y recomendaciones sobre educación en salud a las personas usuarias. Respecto de lo anterior, el objetivo de esta investigación es determinar los conocimientos y la modificación en los estilos de vidas que las personas realizan posterior a la visita del ATAPS.El diseño del estudio fue cualitativo, analítico y observacional. Para la recolección de los datos se aplicó entrevistas a profundidad a las personas usuarias visitadas y se realizó un grupo focal con los ATAPS. Para el análisis de los datos, se estableció categorías de análisis desde la metodología de la teoría fundamentada. Se identificó que las personas usuarias refieren un mayor adquisición de conocimientos cuando se abordó temas como dengue, la vacunación, el lavado de manos, la citología vaginal y una alimentación saludable y un predominio significativo del ama de casa en la participación de esta actividad, lo que al final limita la transmisibilidad de la información al resto de los integrantes. Con respecto a la modificación de prácticas, la mayoría de las personas expresan cambios en estilos de vida saludable y mayores facilidades para el acceso a los servicios de salud. Se concluye que es importante entender la visita domiciliaria como un medio de aproximación entre las familias y el sistema de salud, que favorezca el acceso a los servicios de salud, mientras se constituye en un instrumento que humaniza la atención de las necesidades.

Abstract The home visit made by the technical assistant of primary health care (ATAPS), corresponds to the main primary care activity developed in Costa Rica, whose main task is to provide information and recommendations on health education to users. Regarding the above, the objective of this research is to determine the knowledge and the modification in the lifestyles that people make after the ATAPS visit. The design of the study was qualitative, analytical and observational. For the data collection, in-depth interviews were applied to the users visited and a focus group was made with the ATAPS. For the analysis of the data, categories of analysis were established from the methodology of the grounded theory. It was identified that users report a greater acquisition of knowledge when addressing issues such as dengue, vaccination, hand washing, vaginal cytology and healthy eating and a significant predominance of the housewife in the participation of this activity, which in the end limits the transmissibility of the information to the rest of the members. With respect to the modification of practices, most people express changes in healthy lifestyles and greater facilities for access to health services. It is conclude that it is important to understand the home visit as a means of approximation between families and the health system, which favors access to health services, while providing an instrument that meets the needs.

Resumo A visita domiciliária feita pelo auxiliar técnico de cuidados de saúde primários (ATAPS) corresponde à principal atividade de atenção primária desenvolvida na Costa Rica, cuja principal tarefa é fornecer informações e recomendações sobre educação em saúde aos usuários. No que se refere ao acima, o objetivo desta pesquisa é determinar o conhecimento e a modificação nos estilos de vida que as pessoas fazem após a visita ATAPS. O design do estudo foi qualitativo, analítico e observacional. Para a coleta de dados, foram aplicadas entrevistas em profundidade aos usuários visitados e um grupo focal foi feito com o ATAPS. Para a análise dos dados, as categorias de análise foram estabelecidas a partir da metodologia da teoria fundamentada. Foi identificado que os usuários relatam uma maior aquisição de conhecimento ao abordar questões como dengue, vacinação, lavagem das mãos, citologia vaginal e alimentação saudável e uma significativa predominância significativa da dona de casa na participação desta atividade, que no final limita a transmissibilidade da informação ao resto dos membros. Com respeito à modificação de práticas, a maioria das pessoas expressa mudanças em estilos de vida saudáveis ​​e maiores facilidades para acesso a serviços de saúde.Conclui-se que é importante compreender a visita domiciliar como meio de aproximação entre as famílias e o sistema de saúde, o que favorece o acesso aos serviços de saúde, ao mesmo tempo que fornece um instrumento que atenda ás necessidades.

Cuidado colaborativo entre os Núcleos de Apoio à Saúde da Família e as equipes apoiadas / Collaborative care among the Family Health Support Centers and the supported teams

Resumo O cuidado colaborativo é apresentado como estratégia para ampliar a resolutividade na Atenção Primária à Saúde. Esse estudo analisa o cuidado colaborativo exercido entre os Núcleos de Apoio à Saúde da Família e as equipes de referência com base no Apoio Matricial. Pesquisa qualitativa desenvolvida em seis municípios da Bahia. Foram realizadas entrevistas com 43 profissionais dos núcleos de apoio e 40 das Equipes de Saúde da Família. Foi utilizada como matriz analítica o modelo da colaboração interprofissional, composto pelas dimensões: Compreensão; Internalização; Governança; e Formalização. Nas quatro dimensões, evidenciaram-se dificuldades para a colaboração interprofissional. O trabalho colaborativo e a metodologia do Apoio Matricial são incompreendidas por ambas as equipes. Demonstrou-se existir tensionamentos sobre a função do matriciamento, com polarização entre as atividades coletivas e individuais. As gestões municipais não dão a direcionalidade adequada à prática colaborativa. Condições estruturais, materiais e formativas constituem-se em limitadores do Apoio Matricial. O trabalho entre os núcleos de apoio e as equipes apoiadas demonstra-se fragmentado e com baixa coesão necessária à atividade colaborativa.

Abstract Collaborative care is presented as a strategy to increase resolutiveness in Primary Health Care. This study analyzes the collaborative care between the Family Health Support Centers and the reference teams based on the Matrix Support. Qualitative research developed in six municipalities of Bahia state, Brazil, with interviews conducted with 43 professionals from the support groups and 40 from the Family Health Teams. The model of the inter-professional collaboration was composed by the dimensions: Understanding; Internalization; Governance; and Formalization. In the four dimensions, there were difficulties for inter-professional collaboration. The collaborative work and the Matrix Support methodology are misunderstood by both teams. Tension exists on the function of matriciation, with polarization between collective and individual activities. Municipal management does not give adequate directivity to the collaborative practice. Structural, material and formative conditions are limits for the Matrix Support. The work between the support nuclei and the supported teams is fragmented and with low cohesion necessary for the collaborative activity.

Visita domiciliaria: un espacio para la adquisición y modificación de prácticas en salud / Domiciliary attention: a space for acquiring and modifying health practices

Resumen La visita domiciliaria realizada por el Asistente Técnico de Atención Primaria (ATAPS), constituye una de las principales herramientas de la estrategia de Atención Primaria desarrolladas en Costa Rica; buscando acercar los servicios de salud hasta la vivienda, informando a las familias sobe temas que mejore sus prácticas en salud. El objetivo de esta investigación es determinar los conocimientos y la modificación en los estilos de vidas que las personas realizan posterior a la visita del ATAPS. La metodología de elección fue cualitativa. Para la recolección de los datos se aplicaron entrevistas a profundidad a las personas usuarias visitadas y se realizó un grupo focal con los ATAPS. Para el análisis de los datos establecieron categorías de análisis bajo la metodología de la Teoría Fundamentada. La principal categoría relacionada a la adquisición de conocimientos fue la "educación en salud", en donde se identificó una mayor afinidad de la población hacia temas como dengue, la vacunación, el lavado de manos, la citología vaginal y una alimentación saludable y un predominio importante del ama de casa en la participación de esta actividad, lo que al final limita la transmisibilidad de la información al resto de los integrantes. Las personas participantes afirmaron que los temas tratados les permiten refrescar conocimientos y mantenerse actualizados, reafirmando la importancia de las temáticas abordadas por el ATAPS. Con respecto a la modificación de prácticas, la mayoría de las personas expresan cambios en estilos de vida saludable y mayores facilidades para el acceso a los servicios de salud.

Abstract The home visit by the Technical Assistant Primary Care (ATAPS), is one of the main tools of the Primary Care Strategy developed in Costa Rica; seeking to bring health services to the housing, reporting a sobe Families Topics improve its health practices. The objective of esta research is to determine the knowledge and the change in the lifestyles that people do after the visit of ATAPS. The methodology was qualitative choice. To collect the data is applied a depth Interviews To the users visited and UN focal group was made with the ATAPS. For the Analysis of Data Analysis categories established under the methodology of grounded theory. The director Related to the acquisition of knowledge category was the "Health education", where a mayor affinity of the population identified toward topics like dengue, vaccination, hand washing, vaginal cytology and healthy eating Prevalence UN and additional The Housewife in the share of this activity, which ultimately limits the Transferability of cabbage Information other members. The participants said that the topics covered allow them to refresh knowledge and keep updated, reaffirming the importance of the topics addressed by the ATAPS. With regard to the modification of practices, most of the personalities expressed Changes Healthy Lifestyles and older para facilities Access to Health Services.

La formación de tecnólogos en Higiene y Epidemiología en Cuba: antecedentes y perspectivas / The training of technologists in Hygiene and Epidemiology in Cuba: background and perspectives

La política de desarrollo de recursos humanos ha sido factor de máxima relevancia en la estrategia cubana para la creación y consolidación de su sistema de salud. En el presente trabajo los autores reflexionan sobre la evolución histórica y perspectivas en la formación de los tecnólogos de la salud en el área de la Higiene y Epidemiología, teniendo en cuenta los nuevos retos y problemas epidemiológicos a los cuales se enfrenta hoy no solo Cuba, sino el resto del mundo de forma generalizada. Se caracterizan las etapas de la formación de técnicos medios y tecnólogos en el área de la Higiene y Epidemiología en Cuba, atendiendo a las peculiaridades en los currículos. Se aborda el actual modelo del Licenciado en Higiene y Epidemiología y se muestra el impacto social del rediseño de la carrera, que ha dado respuesta a las exigencias de los servicios de salud cubanos.

The human resources development policy has been a major factor in the Cuban strategy for the creation and consolidation of its health system. In the present work the authors reflect on the historical evolution and perspectives in the training of the health technologists in the area of Hygiene and Epidemiology, taking into account the new challenges and epidemiological problems that are facing not only Cuba but also the rest of the world in a generalized way. The stages of the training of technicians and technologists in the area of Hygiene and Epidemiology in Cuba are characterized, taking into account the peculiarities in the curricula. It addresses the current model of the Bachelor in Hygiene and Epidemiology and shows the social impact of the career redesign, which has met the demands of the Cuban health services.

Estímulos económicos, productividad y salud en docentes de la Universidad Autónoma Benito Juárez de Oaxaca / Economic stimulus, productivity and health in teachers of Benito Juárez Autonomous University of Oaxaca

El estudio tiene como objetivo describir la asociación entre el trabajo que tienen que realizar los académicos universitarios de Oaxaca para alcanzar los estímulos académicos, en relación con su salud física y mental. Se realizó un estudio transversal y descriptivo. Se calculó una muestra aleatoria representativa de cinco facultades de la Universidad Autónoma Benito Juárez de Oaxaca (Odontología, Contaduría y Administración, Idiomas, Arquitectura y Ciencias Químicas). Se aplicó una encuesta para recabar información demográfica, del trabajo y de salud. Las exigencias más importantes fueron: cubrir un determinado número de cursos, clases, artículos y conferencias; estar fijo en el lugar de trabajo; jornada laboral de más de 48 horas semanales; realizar trabajos pendientes en horas de descanso o vacaciones; y trabajar adoptando posiciones incómodas o forzadas. Cuatro de siete consecuencias de la participación en un programa de becas se perfilaron como negativas y se asociaron estadísticamente con trastornos tales como el distrés, trastornos del sueño, presencia de depresión y ansiedad(AU)

This cross-sectional study describes the association between incentive-driven tasks performed by university faculty in and their physical and mental health. A representative random sample of five colleges of the Universidad Autónoma Benito Juárez de Oaxaca (Dentistry, Accounting and Management, Languages, Architecture and Chemical Sciences) was obtained. A survey was used to collect information on demographics, job tasks and health. The most important tasks were: 1) completing a certain number of courses, classes, articles and conferences; being fixed in the workplace; working more than 48 hours per week; performing work during breaks or when on vacation; and working while adopting uncomfortable or awkward positions. Four of seven consequences of participation in a scholarship program were considered negative and statistically associated with disorders such as distress, sleep disorders, presence of depression and anxiety(AU)

Condições de trabalho dos trabalhadores da saúde: um enfoque sobre os técnicos e auxiliares de nível médio / Healthcare Workers' Work Conditions: a perspective on technicians and midlevel workers

Objetivo: analisar as percepções sobre as condições de trabalho do pessoal técnico de nível médio das Unidades Básicas de Saúde (UBS) de Fortaleza, Ceará. Métodos: o percurso metodológico incluiu observação de postos de trabalho e entrevistas semiestruturadas com 25 profissionais auxiliares ou técnicos administrativos, auxiliares ou técnicos em saúde bucal e auxiliares ou técnicos de enfermagem, de 12 UBS do Sistema Único de Saúde (SUS) da cidade de Fortaleza, no ano de 2012. Resultados: os resultados mostraram que as condições de trabalho e, como consequência, as condições do atendimento aos usuários são precárias tanto no que se refere à infraestrutura das unidades quanto em relação à organização das tarefas e das atividades dos técnicos. Conclusão: os custos desse trabalho, realizado em condições precárias, refletem-se sobre a saúde desses profissionais, que se mostram exaustos física e emocionalmente, além de repercutirem na precariedade da atenção à saúde dos usuários do SUS.

Objective: to analyze the perceptions on working conditions of midlevel technical staff from UBS (Basic Health Units) of Fortaleza, Ceará, Brazil. Methods: work places observation and semi structured interviews with 25 midlevel technical professionals - administrative, dental health and nursing assistants - of 12 UBS of the public health system of Fortaleza, during 2012. Results: the results showed that the working conditions and, therefore, user care, are precarious regarding both units’ infrastructure and organization of the midlevel technicians' tasks and activities. Conclusion: the costs of such work, conducted in precarious conditions, are reflected on the professionals' health that reveal themselves physically and emotionally exhausted and ultimately reflect the precariousness of the Public Health System (SUS).

A atuação da educação física nas residências multiprofissionais em saúde / Performance of physical education in multiprofessional health residency / La actuación de la educación física en las residências multiprofesionales en salud

Objetivo: Apresentar as atividades de competência e atuação da Educação Física nas residências multiprofissionais em saúde e as dificuldades dessa experiência. Síntese dos dados: Apresentam-se as atividades de competência e atuação no Sistema Único de Saúde (SUS) da Residência Integrada Multiprofissional Hospitalar com Ênfase na Atenção à Saúde Cardiometabólica do Adulto (RIMHAS) e da Residência Multiprofissional em Saúde da Família (RMSF), supervisionadas pela Comissão das Residências Multiprofissionais (COREMU), ambas com atenção à saúde dos usuários do SUS e duração de dois anos. No que diz respeito à atuação dos residentes, no primeiro ano na RIMHAS, as atividades são desenvolvidas no Hospital Universitário da Universidade Federal do Rio Grande (FURG), no Serviço de Pronto Atendimento, Clínica Médica e Clínica Cirúrgica; no segundo, ocorrem no Centro Integrado de Diabetes e Centro de Reabilitação Física. Na RMSF, há uma imersão em uma equipe de Estratégia de Saúde da Família, com atuação em uma Unidade Básica de Saúde, além da realização de estágios em outros serviços. Conclusão: O estudo mostra que experiências que articulam a formação acadêmica do núcleo da Educação Física e o SUS contribuem para a construção de um canal de diálogo entre indivíduos atuantes nas residências multiprofissionais.

Objetive: To present the activities under the competence of physical education and its performance in the multidisciplinary residences in health and the difficulties involved in this experience. Data synthesis: The study presented the activities of competence and the performance in the Unified Health System (Serviço Único de Saúde - SUS) of the Hospital Multiprofessional Integrated Residency Program with emphasis on Adults? CardiometabolicHealthcare (Residência Integrada Multiprofissional Hospitalar - RIHMAS) and the Multiprofessional Residency Program in Family Health (Residência Multiprofissional em Saúde da Família - RMSF), supervised by the Commission of Multidisciplinary Residences (Comissão das Residências Multiprofissionais - COREMU), both with two-year duration, aiming healthcare for SUS users. As regards the actions of residents, all activities take place at the University Hospital of the Federal University of Rio Grande (FURG); in their first year in RIMHAS, the activities are developed in the Emergency room, Medical and Surgical Clinic; in the second one, they occur in the Integrated Center for Diabetes and Physical Rehabilitation Centre. In RMSF there is a dip in the Family Health Strategy, carrying out activities in a Basic Health Unit, in addition to internships in other health services. Conclusion: The study shows that experiences that link the academic training of the Physical Education core and the SUS contribute to open a channel of dialogue between individuals acting in multiprofessional residency programs.

Objetivo: Presentar las actividades de competencia y actuación de la Educación Física en las residencias multiprofesionales en salud y las dificultades de esa experiencia. Síntesis de los datos: Se presentan las actividades de competencia y actuación en el Sistema de Salud (SUS) de la Residencia Integrada Multiprofesional Hospitalario con Énfasis en la Atención a La Salud Cardiometabólica del Adulto (RIMHAS) y de la Residencia Multiprofesional en Salud de la Familia (RMSF), supervisionadas por la Comisión de las Residencias Multiprofesionales (COREMU), ambas con atención a la salud de los usuarios del SUS y duración de dos años. Respecto la actuación de los residentes, en el primer año de la RIMHAS, las actividades son desarrolladas en el Hospital Universitario de la Universidad Federal de Rio Grande (FURG),en el Servicio de Pronta Asistencia, Clínica Médica y Clínica Quirúrgica. En el segundo año las actividades se dan en el Centro Integrado de Diabetes y Centro de Rehabilitación Física. En La RMSF hay una inmersión en un equipo de Estrategia de Salud de la Familia con actuación en una Unidad Básica de Salud, además de la realización de prácticas en otros servicios. Conclusión: El estudio muestra que las experiencias que involucran la formación académica del núcleo de Educación Física y el SUS contribuyen para la construcción del dialogo entre los individuos de las residencias multiprofesionales.

Conocimientos sobre la enfermedad renal crónica y el proceder de hemodiálisis / Knowledge about chronic kidney disease and hemodialysis procedure

Introducción: el consentimiento informado supone un proceso que va más allá de la firma de un documento de autorización. Objetivo: determinar el nivel de conocimientos sobre la enfermedad renal crónica y el proceder de hemodiálisis de los pacientes del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río en el período comprendido de marzo a mayo de 2012. Material y método: se realizó un estudio observacional, descriptivo, transversal y aplicado. El universo estuvo constituido por los pacientes que reciben hemodiálisis (N = 102). La muestra estuvo integrada por los pacientes que recibieron hemodiálisis el día escogido para aplicar la encuesta que debió coincidir con la segunda sesión de hemodiálisis de la semana, utilizando un método aleatorio simple (n= 85), a los que se aplicó una encuesta formulario. Para determinar la asociación entre variables se utilizó el estadígrafo ji cuadrado al 95 % de confianza. Resultados: la muestra resultó ser mayoritariamente joven, con bajo nivel educacional, siendo el dominio de la enfermedad bastante bajo, y aún más crítico el conocimiento sobre posibles complicaciones durante la hemodiálisis, cuestiones evitables de existir un documento informador previo a este proceder. Conclusiones: los pacientes con enfermedad renal crónica y con tratamientos depuradores, como la hemodiálisis, necesitan la existencia de un consentimiento informado, que sea adaptable a cada paciente, para prepararlos mejor y así lograr bienestar, confort y su total cooperación.

Introduction: informed knowledge involves a process that goes beyond the signing of an authorization document. Objective: to determine the level of knowledge about the chronic kidney disease and the hemodialysis procedure by the patients of Abel Santamaría Cuadrado General Teaching Hospital of Pinar del Río, in the period between March and May 2012. Material and method: an observational, descriptive, cross-sectional and applied study was performed. The universe was made up of the patients undergoing hemodialysis (n=120). The sample was composed by the patients who underwent hemodialysis on the days chosen for applying the survey, which should coincide with the second session of hemodialysis within the week, using the random simple method (n=85), whom were conducted the questionnaire-survey on. To determine association amongst variables, the statistical chi-square test was used at 95% of confidence. Results: the sample came to be mostly young, with low schooling, being also low their knowledge on the disease, and even more critical their knowledge about potential complications in hemodialysis, matters evitable to occur in an authorization document before this procedure. Conclusions: patients with chronic kidney disease and with purifying treatments, as hemodialysis, need to know about a proper informed concernment, applicable to each patient, in order to better prepare them and in doing so to achieve welfare, comfort and their total recovery.

Dental auxiliaries versus community health workers: similarities and contrasts / Profissionais auxiliares da odontologia versus agente comunitário de saúde: similaridades e contrastes

Introdução: Os profissionais auxiliares da odontologia e os agentes comunitários de saúde (ACS's) são profissionais que representam importante segmento na Estratégia Saúde da Família e possuem funções diversificadas. Objetivo: Analisar as atribuições dos auxiliares de cirurgiões-dentistas e dos agentes comunitários de saúde, tanto no aspecto da utilização de seus serviços como na formação, identificando as similaridades e contrastes entre os profissionais da saúde da família, Brasil. Metodologia: Estudo quantitativo e censitário conduzido no âmbito do Programa de Educação pelo Trabalho em Saúde- PET-Saúde, 2010-2012. O instrumento de coleta de dados foi um questionário semiestruturado. A análise considerou o nível de significância p<0,05. Resultado: Participaram 29 profissionais auxiliares da odontologia e 241 ACS's. As funções relacionadas ao contexto comunitário, como conhecer as condições de saúde do território, identificar situação de risco das famílias, visita domiciliar estiveram mais associadas ao ACS's (p<0,05). Em contraste, atividades no ambiente clínico como auxiliar profissional de nível superior e realizar procedimentos clínicos são ações predominantemente dos técnicos/auxiliares da odontologia (p<0,05). As categorias profissionais apresentaram similaridades na prática de vigilância à saúde, reflexão do trabalho em equipe e educação e mobilidade comunitária (p>0,05). Conclusão: Similaridades e contrastes foram identificados entre as ações dos profissionais. A categoria auxiliar em odontologia, apesar de funções específicas no ambiente clínico, ao integrar-se à equipe saúde da família reorienta a prática profissional assumindo ações no âmbito coletivo e familiar.

Introduction: The dental auxiliaries and the community health workers (CHWs) are practitioners that represent an important part in the Family Health Policy in Brazil and have several tasks. Objective: To analyze the attributes of the dental auxiliaries and of the CHWs, regarding the application of their services and their education/training, to identify the similarities and contrasts between these health care practitioners. Methodology: Quantitative and census method data collection performed on the context of the Education Program for Health Workers - PET-Saúde, 2010-2012. The data collection method was a semi-structured questionnaire. The analysis has a level of significance of p<0.05. Result: In this paper, 29 dental auxiliaries and 241 CHWs have participated in the surveys. The assignments that take place on the community context, such as home visits were more associated to the CHWs (p<0.05). On the other hand, the activities that happen on a clinical environment, such as providing assistance to graduated health professionals and performing clinical procedures, are more commonly performed by the dental assistant (p<0.05). Both categories presented similarities performing preventive health care, teamwork analysis, informative initiatives and community mobilization routines (p>0.05). Conclusion: Similarities and contrasts were identified between these health care workers. The dental auxiliaries, despite being mostly issued to specific assignments on a clinical environment, are able to shift their praxis by taking actions on a family and community context once integrated to a family health team.

Work and care in the actions of the nursing technician: a descriptive study

This is a study linked to the Academic Masters in Health Care Sciences of Aurora de Afonso Costa Nursing School. Primary Aim: To identify the work processes of nursing technicians in a hospital environment. Method: This is a descriptive study, adopting a qualitative approach, to be performed with regard to nursing technicians who work in the Medical Clinic Infirmary of Macaé Public Hospital. To collect the data,semi-structured interviews will be used, during the period from August to December 2013. The data analysis will start from the sensitive core, with the analysis of content, according to Bardin...

Avaliação das atitudes profissionais nas práticas educativas em diabetes mellitus na atenção primária / Evaluation of attitudes professionals in educational practices in diabetes mellitus in primary care

Introdução: Devido ao aumento do número de usuários com DM2, faz-se necessário identificar fatores que influenciam positivamente no controle da doença. Estas prioridades antecipam os resultados focalizados nas atitudes dos profissionais de saúde que devem responder as queixas emocionais e as metas dos usuários para uma boa condução das práticas educativas, agindo como facilitadores para um pensar crítico e um agir com autonomia a fim de definir metas conforme seu contexto de vida, levando os usuários a se conscientizarem de que suas ações fazem a diferença no tratamento da doença. Objetivo:Avaliar se as oficinas desenvolvidas com os profissionais de saúde favorecerão as atitudes baseadas nos problemas, nos sentimentos e nas metas apresentados pelos usuários nas práticas educativas em DM2. Metodologia:Trata-se de um estudo quase-experimental com abordagem quantitativa desenvolvido em um grupo intervenção e um grupo controle, nos quais optou-se pelo modelo experimental de pré-teste e de pós-teste. A população foi composta por 26 profissionais de saúde de oito UBS, da região Leste de Belo Horizonte (MG), sendo 12 alocadas no Grupo Intervenção, que participaram das oficinas de capacitação profissional, e 14 alocados para o Grupo Controle, que receberam o Manual de Atitudes Profissionais nas Práticas educativas em DM2. Utilizou-se um Formulário de Identificação Profissional e o protocolo “Responding to Emotion Concerns” (REC), que avalia as atitudes psicológicas do profissional de saúde frente às queixas apresentadas pelos usuários. Os instrumentos foram aplicados no pré-teste e pós-teste nos Grupos Intervenção e Controle. As análises estatísticas foram realizadas no ambiente de programação estatística R (R Development Core Team, 2012) e foi utilizado o teste de Wilcoxon. Resultados: Apontam que no pré-teste aplicado nos dois Grupos, os profissionais de saúde apresentaram predominantemente atitudes favoráveis ao Julgamento e à Solução dos...

Introduction: Due to the increase of users with DM2, it is necessary to identify factors that influence positively in controlling the disease. These priorities anticipate the results focused on the attitudes of health professionals who must respond to complaints and emotional goals of the users for a smooth conduct of educational practices, acting as facilitators for a critical thinking and act with autonomy to define their goals as life context, leading users to be aware that their actions make a difference in the treatment of disease. Objective: To determine if the workshops developed with health professionals favor the attitudes based on problems, feelings and goals presented by users in educational practices in DM2. Methodology: This was a quasi-experimental study with a quantitative approach developed in an intervention group and a control group, in which we chose the experimental model of pre-test and post-test. The population was composed of 26 health professionals from eight UBS, the eastern region of Belo Horizonte (MG), 12 were assigned to the intervention group and 14 control group. We used a form of Professional Identification and protocol "Responding to Concerns Emotion" (REC), which assesses the psychological attitudes of health professionals in the face of complaints from users. The protocol was applied before the completion of professional training workshops and after the intervention and control groups. Statistical analyzes were performed in R statistical programming environment (R Development Core Team, 2012) and we used the Wilcoxon test. Results: Point out that health professionals before professional training workshops showed mostly favorable attitudes to the Judgment of the problems and the solution to the user, configuring, therefore, not a relationship based on dialogue. The professional training workshops conducted with the intervention group showed statistically significant changes in the attitudes of profissinais...

Perfil dos alunos dos cursos de técnico em prótese dentária do estado da Paraíba / Profile of students of the dental technician courses in the state of Paraíba

Objetivo: caracterizar o perfil dos alunos dos cursos técnicos em prótese dentária do Estado da Paraíba, Brasil. Metodologia: realizou-se um estudo observacional, transversal e descritivo. O universoda pesquisa compreendeu todos os estudantes de 18 a 61 anos de idade regularmente matriculados nos cursos de formação de Técnicos em Prótese Dentária(TPD) do estado da Paraíba. A amostra do tipo não probabilística foi composta por114 alunos, em ambos os sexos. A coleta de dados foi realizada por um examinador nas 4 escolas existentes no estado, mediante aplicação de questionário específico. Os dados foram organizados com o software Excel®. Resultados: a maioria dos alunos é do sexo masculino (59,6%), têm entre 30 e 39anos (41,2%), possuem renda familiar de até 2 salários mínimos (46,5%), são casados(56,1%) e oriundos do estado da Paraíba (46,4%). Mais de um terço dos alunos(38,6%) possuem parentes atuando como TPD. O principal motivo para escolha do curso foi a pessoal (37,9%). Verificou-se que 39,5% participaram de congressos e33,3% pretendem trabalhar na área de prótese total. Conclusão: a maioria dos alunos do curso técnico em prótese dentária é do sexo masculino, de baixa renda familiar e casado. Muitos possuem familiares atuando na profissão, sendo a escolha pessoal o fator determinante para o ingresso na profissão. A maioria pretende atuar nas áreas de prótese total e prótese fixa.

Aim: to characterize the profile of students of technical dental courses in the state of Paraiba, Brazil. Methodology: an observational cross-sectional and descriptive study was carried out. The research sample comprised all students aged 18 to 61 years of age enrolled in courses for Dental Technicians (TPD) in Paraíba state. The non-probability sample consisted of 114 students of both genders. Data collection was carried out by an examiner in four schools in the state, and a specific questionnaire was applied. Data were organized in an Excel spreadsheet. Results: most students are male (59.6%), are aged between 30 and 39 (41.2%), have family income of up to two minimum wages (46.5%), are married (56.1%) and from the state of Paraíba (46.4%). More than a third of students (38.6%) have relatives working as DPT. The majority (37.9%) of the sample chose this course for personal reasons. It was found that 39.5% had participated in congresses and 33.3% intend to work in the field of complete dentures. Conclusion: the majority of the students of dental technician courses are male, of lower income and married. Many have relatives working in the profession, the personal choice was the determining factor for entry into the profession and they intend to work in the fields of dentures and fixed prostheses.