The qualitative study of facilitators and barriers to healthy behavior among stroke patients / 中华行为医学与脑科学杂志

Objective:To explore the potential facilitators and barriers to healthy behavior among stroke patients.Methods:Semi-structured interviews were conducted among 16 stroke patients from September 2022 to March 2023 using an objective sampling method.The interview guide was developed using the theoretical domain framework(TDF). Interviews were transcribed and refined the theme using directed content and induction analysis.Using the TDF as the initial coding framework, the themes were then merged into the most relevant domains.Finally, the correspondence between theoretical domains and the healthy behavior of stroke patients was determined based on the frequency and relationship between themes.Results:This study identified nine theoretical domains that affected the healthy behavior of stroke patients: knowledge, skills, motivation and goals, social influences, social/professional role and identity, environment context and resources, belief about capability, consequence belief and behavioral regulation.Conclusion:The healthy behavior of stroke patients is complex and influenced by several factors.The nine theoretical domains identified in this study will provide recommendations for future healthy behavior interventions for stroke patients.

Extension project focused on health education to post-Covid-19 metabolic syndrome patients in the Amazon region / Projeto de extensão voltado a educação em saúde para pacientes com síndrome metabólica pós-infecção de Covid-19 na região Amazônica

In 2020, a new coronavirus strain led to the declaration by the World Health Organization (WHO) of a pandemic global event. With an expansion pandemic to several territories, the involvement of risk groups started to be significantly more evident than healthier patients. Categorized individuals as obese, diagnosed diabetes mellitus type 2 (DM2), and high blood pressure are shown to be more susceptible to severe cases than other individuals, reinforcing even more the greater prevalence of those diseases in our modern world. In the short period since COVID-19 onset cases, few studies could manage to address the diagnostics or even development of long-term symptoms, which sometimes take years to be noticed or start its natural clinic course. With studies showing the possibility of symptoms occurrence or serious deepening of metabolic syndrome in post-infected patients, the health education process aims to establish ways to create and raise awareness about maintaining life quality and healthy eating habits to contribute to a reduction of negative impacts long-term wise caused by a previous metabolic syndrome or started after COVID-19 infection. The extension project focused then on posterior complication development prevention caused by SARS-CoV-2 infection by encouraging a quality lifestyle. The educational booklets and attendance satisfaction questionnaires were tools for better clarification about how to make those quality life-style changes, besides the multidisciplinary attention as an aid to consolidate the health education to the patients. In this way, members of this project sought to foment research activities about this field with still few population studies, encouraging to consolidate the knowledge about the clinical course of this virus. Having contact amongst project members and patients, the construction of relations occurred bilaterally, with intercommunication between academic knowledge and cultural values, bringing a better future change to the patients (AU).

Em 2020, um novo coronavírus acarretou a declaração pela Organização Mundial da Saúde (OMS) de um evento pandêmico global. Com a expansão da pandemia para mais territórios, o acometimento dos grupos de risco passou a ser significativamente mais evidente do que em grupos previamente hígidos. Indivíduos categorizados como obesos, pacientes diagnos-ticados com Diabetes Mellitus tipo 2 (DM2) e hipertensos demonstraram ser mais suscetíveis a casos mais graves do que outras parcelas da sociedade, reforçando ainda mais a grande prevalência dessas doenças no mundo moderno. Pelo período curto desde o início dos casos de COVID-19, poucos estudos conseguem abordar o diagnóstico ou mesmo o desenvolvi-mento das sequelas a longo prazo, o que muitas vezes pode levar anos até serem percebidas ou iniciarem seu curso clínico. Com estudos apontando a possibilidade da ocorrência de sintomas ou agravamento da síndrome metabólica em pacientes pós-infectados, o processo de educação em saúde objetivou estabelecer formas de criar e conscientizar sobre como manter a qualidade de vida e a alimentação saudável, a fim de contribuir para a redução nos impactos negativos a longo prazo da síndrome metabólica prévia ou iniciada após a COVID-19. O projeto de extensão focou, assim, na prevenção do desenvolvimento a posteriori de complicações ocasionadas pela infecção do SARS-Cov-2 por meio do incentivo a um estilo de vida de qualidade. O uso de cartilhas educativas e questionários de satisfação ao atendimento foram ferramentas para o esclarecimento sobre como realizar as mudanças no estilo de vida, além da atenção multidisciplinar como auxílio na consolidação da educação em saúde para estes pacientes. Desta maneira, os integrantes deste projeto buscaram fomentar a pesquisa sobre esta área ainda com poucos estudos populacionais, incentivando a construção de conhecimento sobre o curso clínico deste vírus. Havendo o contato entre os membros do projeto e os pacientes, a construção das relações ocorre bilateralmente, com a intercomunicação entre o conhecimento acadêmico e os valores culturais, trazendo a melhoria futura para os pacientes (AU)

Effects of E-Coaching self-management model on health behavior change in perimenopausal women / 中华健康管理学杂志

Objective:To analyze the influence of E-Coaching self-management model on health behavior change in perimenopausal women.Methods:In this randomized controlled trial, 230 perimenopausal women who participated in health management prograam in the Health Management Center of Hangzhou Wuyunshan Hospital from January 2020 to October 2021 were selected as study objects by convenience sampling method. The subjects were divided into the experimental group and the control group with random number table (115 cases in each group). The experimental group was managed by health coaches with E-Coaching self-management model, and the control group was routinely managed by health managers. The intervention lasted for 6 months. Finally, 29 cases were lost to follow-up due to the failure of the subjects to comply with protocol requirements or voluntary withdrawal. So, a total of 201 subjects were included in the analysis (107 cases in the experimental group and 94 cases in the control group). χ2 test and t test were used to analyze the differences in modified Kupperman symptom score, perimenopausal knowledge and belief, regular exercise and dietary healthy behavior stage between the two groups. And the influence of E-Coaching self-management model on health behavior change in perimenopausal women was analyzed too. Results:After the intervention, the total score of modified Kupperman scale and the scores of insomnia, anxiety and fatigue in the experimental group were all lower than those in the control group [(7.36±2.91) vs (10.01±2.78) points, (0.49±1.13) vs (1.27±1.20) points, (0.80±0.99) vs (1.68±1.39) points, (0.67±0.55) vs (0.93±0.64) points]( t=6.553, 4.785, 5.219, 3.013, all P<0.05); and the total score of knowledge and belief questionnaire and the score of knowledge or belief dimension in the experimental group were significantly higher than those in control group [(25.15±1.55) vs (21.05±1.64) points, (9.61±0.56) vs (9.03±0.68) points, (15.54±1.53) vs (12.02±1.28) points] ( t=-18.238, -6.570, -17.801, all P<0.05). After the intervention, the proportions of the experimental group in the precontemplation and contemplation stage of exercise and diet were both significantly lower than those before intervention ( χ2=116.616, 139.964, both P<0.001), and were lower than those in the control group (the proportion of precontemplation stage of exercise was 7.5% vs 38.3%, and the contemplation stage of exercise was 26.2% vs 34.0%, χ2=38.330; the proportion of precontemplation stage of diet was 3.7% vs 23.4%, and the contemplation stage of diet was 18.7% vs 29.8%, χ2=25.399; all P<0.001). After the intervention, the proportion of the subjects in the preparation stage and action stage the experimental group were significantly higher than those before intervention ( χ2=116.616, 139.964, both P<0.001), and were higher than those in the control group (the proportion in preparation stage of exercise 18.7% vs 8.5%, and the action stage of exercise 47.7% vs 19.1%, χ2=38.330; the proportion in preparation stage of diet 20.6% vs 14.9%, and the action stage of diet 57.0% vs 31.9%, χ2=25.399; all P<0.001). Conclusion:E-Coaching self-management model can improve women′s perimenopausal symptoms in certain degrees, it improves their understanding of perimenopausal knowledge, enhances self-management beliefs and promotes healthy behavior changes.

Diseño de una intervención conductual para el control de peso en mujeres en edad fértil, con sobrepeso u obesidad, residentes de la Ciudad de México / Design of a behavioral intervention for weight control in women of childbearing age, with overweight or obesity, residents of Mexico City

Resumen Entender cómo las personas construyen y modifican sus decisiones y acciones en materia de salud, es indispensable para el abordaje del sobrepeso y la obesidad. El objetivo fue diseñar una intervención en salud que fomente el cambio de comportamientos que favorezcan la adherencia a un plan de alimentación y actividad física en mujeres en edad fértil. Se realizó un análisis mixto que incluyó la revisión de 193 expedientes clínicos en un consultorio privado de nutrición y la aplicación de 16 entrevistas semiestructuradas a mujeres con sobrepeso y obesidad, entre 20 y 49 años, con intención y sin intención de perder peso, para identificar factores relacionados con el aumento de peso. A partir de esto se diseñó una intervención en salud que busca fomentar el cambio de comportamientos para la pérdida de peso, a partir de modelos de cambio de comportamiento. Se encontró que factores relacionados con actitudes, normas percibidas y agencia personal estructuran el cambio de comportamiento y estos fueron distintos cuando sí hay intención de perder peso. Las intervenciones para control de peso deberían buscar la adherencia terapéutica; fomentar el fortalecimiento y creación de redes de apoyo; identificar y abordar las barreras de adherencia y adaptarse a las necesidades individuales.

Abstract To understand how people construct and modify their decisions and actions in health matters, is an essential requirement for the treatment of overweight and obesity. The objective was designing a health intervention that encourages behavior change that favors adherence to a diet and a physical activity plan in women of childbearing age. A mixed analysis was carried out that included the review of 193 clinical records in a private nutrition practice and the application of 16 semi-structured interviews to women with overweight, between 20 and 49 years old, with and without intention of losing weight, to identify factors related to the development of overweight. Based on this, a health intervention was designed to promote behavior change for weight loss, from de thranstheoretical model of change and integrated behavior. Factors related to attitudes, perceived norms, and personal agency were found to structure behavior change, and these were different when there is an intention to lose weight. Weight control interventions should seek adherence; promote the strengthening and creation of support social networks; identify and address barriers to adherence; adapt to the needs of the individual.

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study

ABSTRACT BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Adolescent Lifestyle Profile-Revised 2: validity and reliability among adolescents in Chile

Abstract Objective: The aims of this study were twofold. First, to provide evidence of the validity and reliability of the Adolescent Lifestyle Profile-Revised 2 (ALP-R2) among adolescents in Chile; and second, to examine the relationship between the health-promoting behaviors measured by this scale and several demographic variables. Methods: Cross-sectional survey. Students attending grades 9 through 12 from schools representing low-, middle-, and high-income families were included. All schools were in the city of San Felipe, Chile. Students completed the ALP-R2, a fourty-four-item scale aiming to assess health-promoting behaviors. To evaluate validity and reliability, confirmatory factor analysis and omega coefficient calculation were conducted, respectively. Results: The sample size was 572 students (82.5% of the eligible population). More males (56.6%) than females (43.4%) participated in the study, and the mean age was 16.4 (SD, 1.3) years. The ALP-R2 had adequate adjustment indicators in the confirmatory factor analysis, which means that the data supports the original theoretical model (seven subscales). The highest internal consistency was obtained for the total scale (Ω = 0.87); and (among the subscales), physical activity (Ω = 0.85) and spiritual health (Ω = 0.78) had the highest reliability. Conclusions: The ALP-R2 appears to be a valid and reliable instrument to assess health-promoting behaviors among adolescents attending secondary schools.

Aproximaciones teóricas sobre el aprendizaje cooperativo para la educación en salud en el contexto universitario / Theoretical approaches on the cooperative learning for education in health in the university context

Se realizó una revisión bibliográfica exhaustiva, con el objetivo de analizar algunas concepciones teóricas que revelan las potencialidades del aprendizaje cooperativo, como método para la educación en salud, en el proceso de formación universitaria. Para ello se efectuó un estudio documental contentivo de planes y programas de estudio, de artículos científicos y de tesis doctorales; entrevistas a estudiantes, profesores e investigadores universitarios, así como la observación de los comportamientos y modos de actuación relacionados con el aprendizaje cooperativo de los estudiantes en sus diferentes contextos de formación. El estudio desarrollado verificó que existen insuficiencias teóricas sobre el conocimiento del aprendizaje cooperativo (AC) como método para educar en salud desde el proceso de formación del estudiante universitario.

An exhaustive literature review was carried out with the objective of analyzing some theoretical conceptions that reveal the potentialities of the cooperative learning, as method for the education in health, in the process of university training. That is the reason why a documental study, with plans and study programs, scientific articles and doctoral thesis was carried out; also, some students, professors and university investigators were interviewed and the behaviors and performance ways were observed in this respect. The developed study allowed to verify that there are theoretical deficiencies on the knowledge of this learning.

Effects of PRECEDE-PROCEED Model on Behavior of Patients after Total Hip Arthroplasty / 中国康复理论与实践

Objective:To explore the effect of PRECEDE-PROCEED model on health behavior and quality of life of patients after total hip arthroplasty. Methods:From February to December, 2018, 103 patients who underwent primary total hip arthroplasty were divided into control group (n = 51) and intervention group (n = 52). The control group received routine perioperative guidance, while the intervention group received PRECEDE-PROCEED model in addition, in accordance to the nine links of the model, multi-dimensional intervention measures should be formulated with tendency factors, contributing factors and strengthening factors as the core. They were followed up for six months after discharge, and were assessed with Health Promoting Life style Profile II (HPLP II) and the MOS Item Short From Health Survey (SF-36) one, three and six months after discharge, respectively. Results:There was no significant difference in the scores of HPLP II and SF-36 between two groups at discharge (P > 0.05). The scores of HPLP II and SF-36 were higher than in the intervention group than in the control group one, three and six months after discharge (t > 2.307, P < 0.05). Conclusion:PRECEDE- PROCEED model could change the undesirable life behavior after operation, and improve the health behavior and quality of life of patients with total hip arthroplasty.

Study on the impact of Enterostomal Therapist-led case management on self-management of enterostomy patients / 中国实用护理杂志

Objective To explore the effect of case management mode on self-management ability of enterostomy patients. Methods A total of 104 cases of enterostomy patients were divided into 54 cases in control group and 50 cases in experimental group according to admission time.Used Enterostomal Therapist(ET) as the leading organization of the experimental group to establishing personal files by coordinating team psychological counselors, dietitians, specialists and nurses for individualized nursing services. Patients would receive a three-month nursing practice of case management. The control group would be given nursing intervention and health guidance according to the standardized nursing procedure for enterostomy. After discharge, the nurse-in-charge followed up patients′ treatment completion status. The incidence of enterostomy complications and self-management ability of the stoma in two groups were evaluated at 3 months after surgery. Results In experimental group,the nursing management score of enterostomy was 33.48 ± 4.90, the score of information management was 12.84 ± 2.21, thesymptom observation score was 12.36 ± 1.55, the daily life management score was 30.00 ± 3.40, the psychological management score was 11.64 ± 1.55. Meanwhile,in control group, the nursing management score of enterostomy was 29.74 ± 8.34, the score of information management was 12.10 ± 1.74, the symptom observation score was 11.25 ± 2.56, the daily life management score was 26.59 ± 5.22, the psychological management score was 10.74 ± 2.59. Nursing management score of enterostomy, symptom observation, daily life management, psychological management score between two groups showed significant difference (t=1.529-2.808, P<0.01 or 0.05). The incidence of peristomal dermatitis was 8.0% (4/50) in the experimental group, much lower than that in the control group which was 27.8%(15/54).The difference was statistically significant (χ2=6.801, P<0.05). Conclusions Nursing practice of case management can improve the life quality and accelerate the social adaptability of enterostomy patients.

Study on the impact of Enterostomal Therapist-led case management on self-management of enterostomy patients / 中国实用护理杂志

Objective@#To explore the effect of case management mode on self-management ability of enterostomy patients.@*Methods@#A total of 104 cases of enterostomy patients were divided into 54 cases in control group and 50 cases in experimental group according to admission time.Used Enterostomal Therapist(ET) as the leading organization of the experimental group to establishing personal files by coordinating team psychological counselors, dietitians, specialists and nurses for individualized nursing services. Patients would receive a three-month nursing practice of case management. The control group would be given nursing intervention and health guidance according to the standardized nursing procedure for enterostomy. After discharge, the nurse-in-charge followed up patients′ treatment completion status. The incidence of enterostomy complications and self-management ability of the stoma in two groups were evaluated at 3 months after surgery.@*Results@#In experimental group,the nursing management score of enterostomy was 33.48±4.90, the score of information management was 12.84±2.21, thesymptom observation score was 12.36±1.55, the daily life management score was 30.00±3.40, the psychological management score was 11.64±1.55. Meanwhile,in control group, the nursing management score of enterostomy was 29.74±8.34, the score of information management was 12.10±1.74, the symptom observation score was 11.25±2.56, the daily life management score was 26.59±5.22, the psychological management score was 10.74±2.59. Nursing management score of enterostomy, symptom observation, daily life management, psychological management score between two groups showed significant difference(t=1.529-2.808, P<0.01 or 0.05). The incidence of peristomal dermatitis was 8.0% (4/50) in the experimental group, much lower than that in the control group which was 27.8%(15/54).The difference was statistically significant (χ2=6.801, P<0.05).@*Conclusions@#Nursing practice of case management can improve the life quality and accelerate the social adaptability of enterostomy patients.

Adopción de comportamientos saludables en la niñez: análisis del concepto / Adoption of Healthy Forms of Behavior During Childhood: Analysis of the Concept / Adoção de comportamentos saudáveis na infância: análise do conceito

RESUMEN Objetivo: analizar el concepto de adopción de comportamientos saludables en la niñez. Materiales y método: se utilizó la propuesta de Walker y Avant (2005) para examinar las características definitorias y atributos del concepto. La búsqueda bibliográfica se realizó en las bases de datos Science Direct, PubMed y Scielo, en el período comprendido entre el 2000 y 2016. Resultados: la adopción de comportamientos saludables en la niñez hace referencia al proceso de asimilación o apropiación de conductas, que puede ser ordenado, interrumpido o coordinado, o en algunos casos en el más completo desorden; incluye acciones, actitudes, interacciones y emociones del niño hacia su bienestar, las cuales pueden facilitar, reforzar o mejorar la salud. Constituye un proceso de naturaleza evolutiva, continuamente influenciado por el contexto y puede conducir al establecimiento de un hábito. Conclusiones: la clarificación de este concepto amplia el conocimiento acerca de este fenómeno, lo que permitirá consolidar y plantear estrategias de promoción, prevención e intervención, así como guiar la investigación y la práctica de cuidado de enfermería en la niñez.

ABSTRACT Objective: Analyze the concept of the adoption of healthy behavior during childhood. Materials and methods: Walker and Avant's proposal (2005) was used to examine the defining characteristics and attributes of the concept. A bibliographic database search was done in Science Direct, PubMed and Scielo for the period between 2000 and 2016. Results: The adoption of healthy behavior during childhood refers to the process whereby forms of behavior are either assimilated or appropriated. It can be an ordered, interrupted, coordinated or, in some cases, completely disordered process. It includes the child's actions, attitudes, interactions and emotions with respect to his or her their well-being, which can facilitate, reinforce or improve health. It is a process of an evolutionary nature that is continually influenced by the context and can lead to the establishment of a habit. Conclusions: Clarification of this concept broadens what we know about the phenomenon. This, in turn, will make it possible to consolidate and propose strategies for promotion, prevention and intervention, as well as to guide research and the practice of nursing care during childhood.

RESUMO Objetivo: analisar o conceito de adoção de comportamentos saudáveis na infância. Materiais e método: utilizou-se a proposta de Walker e Avant (2005) para examinar as características definidoras e atributos do conceito. A busca bibliográfica foi realizada nas bases de dados Science Direct, PubMed e SciELO, no período compreendido entre 2000 e 2016. Resultados: a adoção de comportamentos saudáveis na infância faz referência ao processo de assimilação ou apropriação de condutas, que pode ser ordenado, interrompido ou coordenado, ou, em alguns casos, na mais completa desorganização; inclui ações, atitudes, interações e emoções da criança sobre seu bem-estar, as quais podem facilitar, reforçar ou melhorar a saúde. Constitui um processo de natureza evolutiva, continuamente influenciado pelo contexto, e pode levar ao estabelecimento de um hábito. Conclusão: o esclarecimento desse conceito amplia o conhecimento acerca do fenômeno, o que permitirá consolidar e propor estratégias de promoção, prevenção e intervenção, bem como orientar a pesquisa e prática de cuidado de enfermagem na infância.

Prevalência e fatores associados à percepção negativa de autocuidado em idosos brasileiros residentes na comunidade / Prevalence of negative perception of self-care among Brazilian older adults living in the community and associated factors

OBJETIVO: Descrever e identificar fatores de natureza sociodemográfica e de comportamentos em saúde associados à percepção negativa de autocuidado em idosos residentes na comunidade de sete cidades brasileiras. MÉTODOS: Trata-se de um estudo transversal com dados do Estudo sobre Fragilidade em Idosos Brasileiros. Foram selecionadas características sociodemográficas, de comportamentos relacionados à saúde e de percepção de autocuidado em saúde. Para as análises, foram estimadas as distribuições percentuais e os respectivos intervalos de confiança de 95%, com nível de significância de 5%. Foi utilizada a análise de regressão logística univariada e multivariada, com critério stepwise de seleção de variáveis. RESULTADOS: Da amostra total de 2.552 idosos, a maioria foi de mulheres (65,8%), com idade média de 72,3 ± 5,5 anos. A pior percepção de autocuidado foi associada à não utilização de serviço odontológico (OR = 1,48; p < 0,001), faixa de renda de 1,1 a 3 salários mínimos (OR = 1,46; p = 0,049), tabagismo (OR = 1,41; p = 0,030), sedentarismo (OR = 1,32; p = 0,003) e sexo masculino (OR = 1,24; p = 0,023). CONCLUSÃO: Embora não tenham sido encontradas altas frequências de comportamentos negativos em saúde, destaca-se a associação com fatores modificáveis, como o sedentarismo e o tabagismo. A ausência de busca por serviços odontológicos continua sendo aspecto desafiador entre idosos. Os resultados apontam para um potencial indicador subjetivo nos levantamentos clínicos e de pesquisa em saúde ao longo do envelhecimento.

OBJECTIVE: To describe and identify sociodemographic factors and health behaviors associated with a negative perception of self-care in community-resident older adults in seven Brazilian cities. METHODS: This is a cross-sectional analysis of data from the Frailty in Brazilian Older Adults (FIBRA) study. Sociodemographic characteristics, health-related behaviors, and perception of self-care in health were assessed. For analysis, percentage distributions and respective 95% confidence intervals were estimated, at a significance level of 5%. Univariate and multivariate logistic regression analyses were carried out, with stepwise variable selection. RESULTS: Of 2,552 older adults in the overall sample, most (65.8%) were women, with a mean age of 72.3 ± 5.5 years. The worst perception of self-care was associated with non-use of dental care services (OR = 1.48, p < 0.001), income range from 1.1 to 3 times the minimum wage (OR = 1.46, p = 0.049), smoking (OR = 1.41, p = 0.030), sedentary lifestyle (OR = 1.32, p = 0.003), and male gender (OR = 1.24, p = 0.023). CONCLUSION: Although no high frequencies of negative health behaviors were found, the association of poor perception of self-care with modifiable factors, such as sedentary lifestyle and smoking, stands out. Failure to seek dental care continues to be a challenging aspect among the elderly. These results point to a potential subjective indicator for clinical and health research surveys throughout the aging process.

Estilos de vida saudável e autoavaliação de saúde como boa: uma análise dos dados da PNS/2013 / Healthy lifestyles and self-rated health as good: an analysis of the PNS/2013

Objetivo: Avaliar a influência de cinco estilos de vida sobre a autoavaliação da saúde como boa no Brasil. Métodos: Estudo transversal utilizando dados da Pesquisa Nacional de Saúde (PNS) realizada em 2013, com amostra de 46.785 indivíduos. O desfecho principal foi a autoavaliação de saúde como boa e utilizou-se a regressão logística para analisar os estilos de vida saudáveis associados a melhor autoavaliação de saúde. Resultados: Encontramos que o tabagismo, o consumo de álcool, a atividade física e a alimentação saudável são comportamentos que estão associados à autoavaliação de saúde. Pessoas que apresentam múltiplos comportamentos saudáveis apresentam chances maiores de avaliar positivamente sua saúde. Conclusão: Políticas de conscientização devem ser realizadas informando a população dos benefícios da adoção de hábitos de vida saudáveis.

Objective: Evaluating the influence of five lifestyles on health self-assessment as good in Brazil. Methods: Cross-sectional descriptive study using data from the National Health Survey (PNS 2013) conducted in 2013, with a sample of 46,785 individuals. The main outcome was self-rated health as good and logistic regression was used to analyze healthy lifestyles associated with better self-rated health. Results: We found that smoking, drinking, physical activity and healthy eating are behaviors that are associated with self-rated health. People who have multiple healthy behaviors are more likely to positively evaluate their health. Conclusion: Awareness policies should be carried out to inform the population of the benefits of adopting a healthy lifestyle.

O conceito de saúde e de hábitos saudáveis em adolescentes escolares / The concept of health and healthy habits in school adolescents / El concepto de salud y de hábitos saludables en adolescentes escolares

O presente estudo teve como objetivo investigar o nível de entendimento de escolares do 1ª ano do Ensino Médio do Instituto Federal Goiano Campus Ceres, com idades entre 14 a 19 anos, acerca do conceito de saúde e de hábitos saudáveis. Participaram desta pesquisa 215 escolares, avaliados por um questionário subjetivo padronizado, composto por 16 questões. Dentre os 215 escolares avaliados, 53% julgam sua saúde boa e revelaram não ter nenhum tipo de doença. Para 69% dos alunos ter saúde significa estar bem, enquanto para 31% é estar bem física e mentalmente. Quanto aos aspectos prejudiciais à saúde mais relatados, 42% dos escolares citaram a má alimentação e a falta de exercícios físicos. Em contrapartida, no que se refere às suas atitudes em busca da melhora da saúde, 26% relataram a prática regular de exercícios físicos. Além disso, 35% responderam que praticar exercícios ou esportes contri-bui para a melhora da saúde e 24% associam a boa alimentação com a prática de exercícios para este mesmo fim. Ainda, 35% responderam não se alimentar corretamente e não praticar nenhum tipo de exercício físico. Quanto aos seus familiares, 33% disseram que estes sabem cuidar de sua saúde. Conclui-se que, em geral, os adolescentes avaliados entendem o conceito de saúde e o que ele representa, afirmando o bem-estar físico e mental, o que pode refletir possivelmente em uma fase adulta com a adoção de um estilo de vida ativo e saudável.

The objective of this study was to investigate the level of understanding about the concept of health and healthy habits among beetween 14 to 19 year-old high school juniors of the Fed-eral Goiano Campus Ceres Institute. Participated of this study 215 students that answered a standardized questionnaire composed of 16 questions. Of the 215 adolescents evaluated, 53% judged their heal thas good and revealed that they did not have any type of disease. For 69% of the students, health means being well, while for 31% is being physically and mental-ly well. As for the mosth arm ful heal tha spects, 42% of school children cited poor dietand lack of exercise. On the other hand, about their attitudes towards health improvement, 26% reported regular physical exercise. In addition, 35% answered that practicing exercises or sports contributes to better health and 24% associate good nutrition with exercise for this purpose. Still, 35% answered not to eat properly and not to practice any type of physical ex-ercise. As for their relatives, 33% said they know how to take care of their health. It is con-cluded that, in general, evaluated adolescents understand the concept of health and what it represents, affirming physical and mental well-being, reflecting possibly in an adult phase adopting an active and healthy life style.

El presente estudio tuvo el objetivo de investigar el nivel de entendimiento de estudiantes del primer año de la Enseñanza Secundaria del Instituto Federal Goiano Campus Ceres, con edades entre 14 y 19 años, sobre el concepto de salud y de hábitos saludables. Participaron de esta investigación 215 estudiantes, evaluados a través de un cuestionario subjetivo estan-darizado, compuesto por 16 preguntas. De los 215 estudiantes evaluados, el 53% juzga su salud buena y reveló que no tenía ningún tipo de enfermedad. Para el 69% de los alumnos, tener salud significa estar bien, mientras que para el 31% es estar bien física y mentalmente. Sobre los aspectos perjudiciales para la salud más relatados, el 42% de los estudiantes citó la mala alimentación y la falta de ejercicios físicos. En cambio, en lo que se refiere a sus acti-tudes en busca de la mejoría de la salud, el 26% relató la práctica regular de ejercicios físi-cos. Además, el 35% respondió que practicar ejercicios o deportes contribuye para la mejoría de la salud y el 24% asocia la buena alimentación a la práctica de ejercicios para esa misma finalidad.. Además, el 35% respondió que no se alimentaba correctamente y no practicaba ningún tipo de ejercicio físico. En relación a sus familiares, el 33% dijo que éstos saben cui-dar su salud. Se concluye que, en general, los adolescentes evaluados entienden el concepto de salud y lo que representa, afirmando el bienestar físico y mental, hecho que tal vez pueda resultar en una fase adulta con la adopción de un estilo de vida activo y saludable.

Effect evaluation of intervene on healthy behavior of soldiers on platesu area to prevent hemorrhoids based on transtheoretical model / 中国实用护理杂志

Objective To explore the effect of trans theoretical model in changing on healthy behavior of soldiers on plateau area to prevent hemorrhoids. Methods Fifty-four soldiers respectively from the artillery troops and air defenses force troops were selected and divided into control group that received normal healthy education and treatment group that received the healthy behavior intervene based on transtheoretical model and the changes of the behavior at each stage of intervention were observed and contrasted between two groups. Results There was no statistically significant difference in the number of each stage between two groups at 1 and 3 months after intervention (χ2= 1.514, 6.554, P> 0.05). The number of former intention stage, intention stage, preparation stage, action stage, maintain stage at 6 months after intervention in treatment group were respectively 0, 0, 0, 15, 39 cases, and 2, 3, 6, 20, 23 cases in control group respectively, the difference was statistically significant (χ2=15.843, P0.05). The number of daily training of the levator ani less than 5, 6-15, 16-25, 26-35,>35 times at 3, 6 months after intervention respectively was 5, 6, 6, 17 cases and 20, 0, 0, 0, 14, 40 cases in treatment group respectively, 9, 13, 14, 10, 8 cases, and 3, 4, 6, 22, 19 cases in control group,the differences were statistically significant (χ2=13.459, 22.252, P<0.01). The incidence of bloody at 6 months after intervention was 3.70% (2/54) in treatment group and 16.67% (9/54) in control group, the difference was statistically significant (χ2 = 4.960, P < 0.05). Conclusions The intervene based on transtheoretical model can effectively promote the healthy behavior to prevent hemorrhoids and reduce the recurrence rate of hemorrhoids.

Effect of timeliness motivation theory-based continuing care on the self-care ability and healthy behavior in elderly patients with type 2 diabetes / 现代临床护理

Objective To explore the effect of timeliness motivation theory-based continuing care on the self-care ability and healthy behavior in elderly patients with type 2 diabetes. Methods A total of 202 elderly patients with type 2 diabetes in our hospital were selected,and were randomly divided into observation group and control group according to the random number table, with 101 cases in each group. The control group were given healthy related education during hospitalization , and post-discharge telephone follow-up every month, lasting 10~15min each time.The observation group were additionally given timeliness motivation theory-based continuing care by telephone follow-up each month , including emotional arousal , need motivation , examples stimulating and benefit motivation, lasting 6 months. Their self-care ability and healthy behavior in the two groups were compared. Result The self-care ability in the observation group was significantly significantly better than that of the control group (P<0.001), and had significantly much more healthy behaviors than the latter (P < 0.001). Conclusion Timeliness motivation theory-based continuing care can improve the self-care ability and healthy behavior in elderly patients with type 2 diabetes.

Hábitos saudáveis: que tipo de orientação a população idosa está recebendo dos profissionais de saúde? / Healthy habits: what kind of guidance the elderly population is receiving from health professionals?

RESUMO: Objetivo: Descrever a prevalência de orientações sobre hábitos saudáveis recebidas de profissionais de saúde entre idosos e sua relação com indicadores socioeconômicos, demográficos, comportamentais, de saúde e do tipo de serviços. Métodos: Estudo transversal, de base populacional, com indivíduos de 60 anos ou mais da zona urbana de Pelotas, Rio Grande do Sul. Foram avaliadas sete orientações sobre hábitos saudáveis: controlar o peso, reduzir o sal, açúcar e gordura, praticar atividade física, não fumar e não ingerir bebidas alcoólicas. Resultados: Entre os 1.451 idosos entrevistados, 1.281 (88,3%) consultaram no último ano. As orientações mais referidas foram para redução do consumo de gordura (61,7%), de sal (61,5%) e prática de atividade física (58,2%). Idosos que consultaram três vezes ou mais e em serviços financiados pelo Sistema Único de Saúde receberam mais orientações. Aqueles idosos de classificação econômica A/B tiveram maior probabilidade de receber orientação para controle de peso (RP = 1,27; IC95% 1,06 - 1,70) e para prática de atividade física (RP = 1,34; IC95% 1,06 - 1,69). Conclusão: As orientações, por profissionais de saúde, foram pouco frequentes e, em alguns casos, desfocalizadas.

ABSTRACT: Objective: To describe the prevalence of guidance on healthy habits received from health professionals by elderly and its relation to socioeconomic demographic, behavioral and health indicators, and the type of services. Methods: Cross sectional population based study including individuals aged 60 years or more in the urban area of Pelotas, Rio Grande do Sul, Brazil. Seven guidance on healthy habits were evaluated: weight control, reduction in salt, sugar and fat intake, physical activity practice, not smoking and not drinking alcohol. Results: Among the 1,451 elderly interviewed, 1,281 (88.3%) consulted in the last year. The orientations more refereed were to fat (61.7%) and salt (61.5%) intake reduction and physical activity (58.2%). Elderly who consulted three times or more and in services financed by the Unified Health System received more guidance. Those elderly from the socioeconomic classes A/B were more likely to receive guidance for weight control (RP = 1.27; 95%CI 1.06 - 1.70) and physical activity (RP = 1.34; 95%CI 1.06 - 1.69). Conclusion: The orientation from health professionals were uncommon and, in some cases, unfocused.

Hábitos de exposição ao sol e uso de fotoproteção entre estudantes universitários de Teresina, Piauí / Habits of sun exposure and sunscreen use among university students from Teresina, Piauí State, Brazil / Hábitos de exposición al sol y uso de fotoprotección entre estudiantes universitarios de Teresina, Piauí, Brasil

Objetivo: investigar hábitos de exposição solar e de fotoproteção entre estudantes universitários de Teresina-PI, Brasil. Método: estudo transversal, com amostra representativa; foram investigadas associações entre características demográficas e hábitos de exposição ao sol e de fotoproteção. Resultados: dos 398 universitários entrevistados, 54,8 por cento informaram expor-se ao sol menos de 2 horas diariamente; a maioria (66,8 por cento) preferia horários de menor intensidade de radiação; 45,2 por cento dos entrevistados referiram uso de filtro solar em seu dia-a-dia, e 82,4 por cento, em exposição voluntária ao sol; o uso de camisetas foi outro recurso de fotoproteção referido (44,2 por cento) e 29,9 por cento dos acadêmicos receberam alguma orientação profissional sobre fotoproteção; as mulheres referiram mais frequentemente do que os homens o uso de fotoprotetores diariamente e em situação de exposição voluntária (p<0,001). Conclusão: a maioria dos universitários referiu preferir horários de baixa intensidade de radiação, fazer uso de filtro solar e de outras medidas de fotoproteção em exposição voluntária ao sol.

Objective: to investigate sun exposure and sunscreen use habits among university students in Teresina-PI. Method: cross-sectional study with a representative sample. Associations between demographic characteristics and sun exposure and sunscreen use habits were investigated. Results: 398 students were interviewed. 54.8 percent reported exposing themselves to the sun less than 2 hours daily. The majority (66.8 percent) preferred times when radiation is less intense. 45.2 percent reported sunscreen use as a daily habit and 82.4 percent reported its use in voluntary sun exposure. T-shirt use was another form of photoprotection reported (44.2 percent) and 29.9 percent of students had received some professional guidance on photoprotection. Females reported daily and voluntary exposure sunscreen use (p <0.001) more often than males. Conclusion: most students referred preferring exposure to the sun at times when radiation intensity is low, using sunscreen and other sun protection measures during voluntary sun exposure.

Objetivo: investigar hábitos de exposición solar y de fotoprotección entre estudiantes universitarios de Teresina-PI, Brasil. Método: estudio transversal, con muestra representativa; se investigaron asociaciones entre características demográficas y hábitos de exposición al sol y de fotoprotección. Resultados: de los 398 universitarios entrevistados, 54,8% informó que se exponía al sol menos de 2 horas diariamente; la mayoría (66,8%) prefiere horarios de menor intensidad de radiación; 45,2% de los entrevistados refirió el uso de filtro solar en su diario vivir, y 82,4%, en exposición voluntaria al sol; el uso de camisetas fue otro recurso de fotoprotección referido (44,2%) y 29,9% de los académicos recibió alguna orientación profesional sobre fotoprotección; las mujeres relataron el uso de fotoprotectores diariamente com más frecuencia que los hombres y en situación de exposición voluntaria (p<0,001). Conclusion: la mayoría de los universitarios relató preferir horarios de baja intensidad de radiación, usar filtro solar y otras medidas de fotoprotección en exposición voluntaria al sol.

Association between leisure-time physical activity and long-term medication use in adults from a low socioeconomic region / Associação entre prática de atividade física no tempo de lazer e medicação permanente em adultos de uma região de baixo nível socioeconômico

Few studies have investigated the association between leisure-time physical activity and long-term medication use in Brazilian populations, especially those of low socioeconomic status. The objective of this study was to analyze the association between the need for long-term medication and leisure-time physical activity in adults from the Ermelino Matarazzo district, a low-income region in São Paulo, Brazil. A population-based cross-sectional study was conducted in 2007 and involved 890 subjects aged 18 years or older. Data regarding the need for long-term medication and types of medications used were collected using a questionnaire. Leisure-time physical activity was measured using the long version of the International Physical Activity Questionnaire. Descriptive analysis, chi-square test, and simple and multiple binary and multinomial logistic regression analysis were used. Among the subjects studied, 29.2% reported the need for long-term medication and 10% required at least two different types of medications. After adjustment for gender, age, education level and Body Mass Index, subjects who did not perform at least 150 min/week of leisure-time physical activity presented 2.78 (95% confidence interval - 95%CI: 1.45; 5.30) and 4.69 (95%CI: 1.90; 11.53) times the odds of requiring long-term medication and two or more types of medications rather than none, respectively, than those who did. Broader discussion of the interaction between medication, leisure-time physical activity and social and economic aspects is needed to reduce inequalities and to improve the health of individuals of low socioeconomic status.

Poucos trabalhos estudaram a associação entre prática de atividade física no tempo de lazer e medicação permanente em brasileiros, especialmente, de baixo nível socioeconômico. O objetivo do estudo foi analisar a associação entre necessidade de medicação permanente e prática de atividade física no tempo de lazer em adultos do distrito de Ermelino Matarazzo, região de baixo nível socioeconômico do município de São Paulo, SP. Estudo transversal de base populacional, realizado em 2007, com 890 pessoas com 18 anos ou mais de idade. Dados sobre necessidade de medicação permanente e tipos de medicamentos foram coletados por questionário. Informações sobre a atividade física de lazer foram obtidas por meio do International Physical Activity Questionnaire (IPAQ), versão longa. Análise descritiva, teste do qui-quadrado e regressões logísticas binárias e multinomiais, simples e múltiplas, foram utilizadas. Observou-se que 29,2% relataram necessitar de medicação permanente e 10% necessitavam dois ou mais tipos diferentes de medicamentos. Após ajustes para sexo, idade, escolaridade e índice de massa corporal, pessoas que não realizavam, pelo menos, 150 min/sem de atividade física no lazer apresentaram odds 2,78 (intervalo de confiança de 95% - IC95%: 1,45; 5,30) e 4,69 (IC95%: 1,90; 11,53) vezes daqueles que realizavam ao menos esse volume de necessitar medicação permanente e de necessitar dois ou mais tipos de medicamentos do que nenhum, respectivamente. Reflexão mais ampla sobre a interação entre medicação, prática de atividade física no lazer e aspectos sociais e econômicos deve ser feita a fim de reduzir desigualdades e melhorar a saúde de pessoas com menores níveis socioeconômicos.

Construction and validation of a questionnaire on the knowledge of healthy habits and risk factors for cardiovascular disease in schoolchildren / Construção e validação de um questionário sobre conhecimento de hábitos saudáveis e fatores de risco para doenças cardiovasculares em estudantes

OBJECTIVES: To develop and analyze the reliability and validity of a questionnaire on the knowledge of healthy habits and risk factors for cardiovascular disease (CARDIOKID) to be used in schoolchildren. METHODS: The study included 145 children aged 7 to 11 years. The measured factors were the knowledge of healthy habits and risk factors for cardiovascular disease. Cronbach's alpha and intra-class correlation coefficient (ICC) were used to verify reliability, and exploratory factor analysis was used to assess the validity of the questionnaire. RESULTS: The sample consisted of 60% females and 40% males. In factorial analysis, the Kaiser-Meyer-Olkin (KMO) test result was measures of sampling adequacy (MSA) = 0.81 and Bartlett's test of sphericity was X2 = (66) = 458.64 (p < 0.001). In the factorial analysis with varimax rotation, two dimensions were defined. The "healthy habits" dimension was composed of five factors (ICC = 0.87 and α = 0.93) and the "cardiovascular risk factors" dimension was composed of seven factors (ICC = 0.83 and α = 0.91). In the individual factor analysis, Cronbach's alphas were between 0.93 and 0.91. Total variance was 46.87%. There were no significant differences between test and retest applications. CONCLUSION: The questionnaire presented satisfactory validity and reliability (internal consistency and reproducibility), allowing for its use in children. .

OBJETIVOS: desenvolver e analisar a fidedignidade e a validade de um questionário sobre conhecimento de hábitos saudáveis e fatores de risco para doenças cardiovasculares (CARDIOKID), para utilização em crianças de idade escolar. MÉTODOS: participaram do estudo 145 crianças de 7 sete a 11 anos de idade. Os fatores mensurados foram o conhecimento sobre hábitos saudáveis e fatores de risco para doenças cardiovasculares. O alfa de Cronbach (α) e a correlação intraclasse (CCI) foram utilizados para verificar a fidedignidade, e a análise fatorial exploratória para avaliar a validade do questionário. RESULTADOS: a amostra foi composta de 60% meninas e 40% meninos. Na análise fatorial, o teste de KMO teve resultado de 0,81 e o teste de esfericidade de Bartlett de X2 = (66) = 458,64 (p < 0,001). Na análise fatorial com rotação varimax, foram definidas duas dimensões: a de "hábitos saudáveis" permaneceu com cinco fatores (CCI = 0,87 com α = 0,93), e a de "fatores de risco para doenças cardiovasculares" com sete fatores (CCI = 0,83 α = 0,91). Na análise de cada fator, o valor encontrado dos alfas de Cronbach manteve-se entre 0,93 e 0,91. A variância total manteve-se em 46,87%. Não houve diferença significativa entre as respostas no teste e reteste (p < 0,292). CONCLUSÃO: o questionário demonstrou consistência interna e reprodutibilidade satisfatórias, possibilitando a sua utilização em crianças. .