Síndrome de Burnout e fatores associados em profissionais da Estratégia Saúde da Família / Burnout syndrome and associated factors among Family Health Strategy professionals / Síndrome de Burnout y factores asociados en profesionales de la Estrategia Salud de la Familia

(AU(Este trabalho objetiva analisar presença de burnout e fatores relacionados em profissionais da Estratégia Saúde da Família. Trata-se de um estudo de delineamento transversal analítico, realizado entre fevereiro e abril de 2019. A amostra contou com 94 profissionais. Foi utilizado formulário com variáveis sociodemográficas, Escala Modo Enfrentamento de Problemas, Escala de Resiliência e Oldenburg Burnout Inventory. Intervalo de confiança de 95% foi calculado para cada variável. Em relação ao perfil de profissionais, a maioria deles eram mulheres, com média de 40,9 anos, 12 anos de trabalho na Atenção Básica e que atuavam no serviço público. A prevalência de burnout foi de 38,3%; sendo 59,6 % para exaustão e 47,9% para distanciamento. Os resultados mostram elevados níveis de burnout, moderada pontuação nos fatores que compõem a resiliência e baixa eficiência no uso de estratégias de combate aos estressores.(AU)

This article aims to analyze the presence of burnout and related factors among Family Health Strategy professionals. A cross-sectional analytical study was carried out between February and April 2019, with a sample composed of 94 professionals. A form with sociodemographic variables was used, as well as the Scale of Ways of Coping with Problems (EMEP), the Resilience Scale and the Oldenburg Burnout Inventory. A 95% confidence interval was calculated to each variable. The study was approved by the Ethics Committee of the Federal University of Piauí under number 3.169.529. The profile was of professionals, the majority of whom were women, with average age of 40.9 years, 12 years of work in Primary Care, public service. Burnout prevalence was 38.3%; 59.6% for exhaustion and 47.9% for distancing. The results show high levels of burnout, a moderate score in the factors that compose resilience and low efficiency in the use of strategies to combat stressors.(AU)

El objetivo de este trabajo es analizar la presencia de Burnout y factores relacionados en profesionales de la Estrategia Salud de la Familia. Estudio de delineamiento transversal analítico, realizado entre febrero y abril de 2019. La muestra contó con 94 profesionales. Se utilizó un formulario con variables sociodemográficas, Escala Mode Enfrentamiento de Problemas, Escala de Resiliencia y Oldenburg Burnout Inventory. Se calculó un intervalo de confianza del 95% para cada variable. El estudio fue aprobado por el Comité de Ética de la Universidad Federal del Estado de Piaui bajo el número 3.169.529. Perfil de profesionales, mayoría de mujeres con promedio de 40,9 años, 12 años de trabajo en la Atención Básica, servicio público. La prevalencia de Burnout fue del 38,3%; siendo el 59,6 % para agotamiento y el 47,9% para distanciamiento. Los resultados muestran elevados niveles de Burnout, puntaje moderado en los factores que componen la resiliencia y baja eficiencia en el uso de estrategias de combate a los factores de estrés.(AU)

Práticas integrativas e complementares aplicadas aos trabalhadores de uma unidade básica de saúde: relato de experiência / Ingration of complementary practices applied to workers of a basic health unit: experience report

Introdução: Um dos desafios do Sistema Único de Saúde (SUS) é conseguir com que os seus trabalhadores e gestores do SUS, nas práticas cotidianas, incorporem ações de autocuidado. Objetivo: Descrever a experiência do projeto CuidAR-TE realizado com trabalhadores da Unidade Básica de Saúde (UBS) Dr. Antônio Carlos Costa, Teresina, Piauí. Materiais e Métodos: Relato de experiência do projeto CuidAR-TE desenvolvido em 2018, com 65 trabalhadores da UBS e estudantes da Residência Multiprofissional em Saúde da Família e Comunidade, da Universidade Estadual do Piauí. Foram realizados encontros mensais, com início no mês de agosto de 2018, e foram discutidas e aplicadas práticas complementares integrativas, a saber: biodança, dança circular, bioenergética, meditação, ioga, eutonia, musicoterapia, arte e saúde, práticas manuais e liangong. Conclusão: A realização dessa experiência mobilizou as equipes a refletirem sobre estratégias para o cuidado dos trabalhadores através de tecnologias leves e das práticas integrativas e complementares que demonstraram resultados positivos para a saúde e qualidade de vida dos atores envolvidos.

Introduction: One of the challenges of the Unified Health System (SUS) is to get its workers and SUS managers, in daily practices, to incorporate self-care actions. Objective: To describe the experience of the Care-TE project carried out with workers from the Basic Health Unit (UBS) Dr. Antônio Carlos Costa, Teresina, Piauí. Materials and Methodology: Experience report of the Care-TE project developed in 2018, with 65 workers from UBS and students from the Multiprofessional Residency in Family and Community Health, State University of Piauí. Monthly meetings were held, beginning in August 2018, and complementary integrative practices were discussed and applied, namely: biodance, circular dance, bioenergetics, meditation, yoga, eutonia, music therapy, art and health, manual practices and liangong. Conclusion: This experience mobilized the teams to reflect on strategies for the care of workers through light technologies and integrative and complementary practices that demonstrated positive results for the health and quality of life of the actors involved.

Effectiveness of Low-Intensity Laser Therapy on Tissue Repair Following Saphenectomy in Patients Who Underwent Coronary Artery Bypass Graft: A Randomized, Double-Blind Study.

OBJECTIVE: To verify the effectiveness of low-intensity laser therapy (LLLT) on tissue repair following saphenectomy during postoperative period in patients having undergone coronary artery bypass graft (CABG). MATERIALS AND METHODS: A randomized clinical trial, controlled and double-blind study was conducted with 40 volunteers, divided into 2 groups: a placebo group (PG, n = 20) and a laser group (LG, n = 20). The patients in the LG group were irradiated with laser during saphenectomy (InGaAlP, λ 660 nm, energy density 6 J/cm2) daily from the first to the fourth postoperative day. The surgical incision was clinically evaluated and imaged at the beginning and at the end of the treatment. The areas of hematoma and hyperemia were evaluated using the software ImageJ 1.4©, and border closure was evaluated by three researchers, who were blinded concerning the allocation of the participants. RESULTS: The LG group presented a reduction of the areas of hematoma and hyperemia (p = 0.0003) and better border closure (p = 0.009), when compared with the PG group. CONCLUSIONS: The proposed LLLT protocol improved the tissue repair following saphenectomy in CABG patients.

Low-intensity LED therapy (λ 640 ± 20 nm) on saphenectomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study.

Myocardial revascularization surgery (CABG) is the most appropriate treatment for coronary artery disease. Currently, the great challenge is to reduce postoperative complications, such as wound infections, dehiscence, pain, and patients' quality of life. The saphenectomy is the target of complications in 10% of cases, which can cause greater morbidity, time, and cost of hospitalization. Studies show that low-intensity laser or light-emitted diode (LED) therapy promotes positive biomodulation of the tissue repair process, culminating in a lower incidence of dehiscence, pain reduction, and improvement in quality of life. The objective of the present study was to evaluate clinically the saphenous tissue repair after LED therapy. Forty subjects of both genders who underwent CABG with extracorporeal circulation were randomly divided into two groups: the placebo (PG) and experimental (EG). The experimental group underwent low-intensity LED therapy (λ 640 ± 20 nm, 6 J/cm2) on saphenectomy. The tissue repair was analyzed by digital photogrammetry on the first and fifth postoperative day. The border closure was blindly evaluated by three researchers. The hematoma and hyperemia area was quantitatively analyzed using ImageJ© software. The results showed that in the experimental group, there were less bleeding points and no dehiscence in saphenectomy, as compared to the placebo group. There was also a smaller area of hematoma and hyperemia in the experimental group (p < 0.0009). These data lead to the conclusion that the type of phototherapy protocol employed can assist in tissue repair.

Desempenho motor de escolares quilombolas entre 8 e 10 anos / Motor performance of quilombola students between 8 and 10 years / Desempeño motor de los escolares quilombolas entre 8 y 10 años

O desenvolvimento motor é uma sequência de etapas evolutivas que ocorre de acordo com a faixa etária, determinado por meio dos requisitos de interação da criança com a tarefa, individualidade biológica e condições do ambiente. O objetivo deste estudo é analisar o desempenho motor de escolares quilombolas entre 8 anos a 10 anos de idade. Trata-se de uma pesquisa quantitativa, do tipo transversal, com amostra constituída por 52 escolares. O instrumento de coleta de dados utilizado foi o protocolo de testes da Escala de Desenvolvimento Motor (EDM) de Rosa Neto. A seleção da amostra foi do tipo intencional. Apresentaram classificação normal médio as variáveis coordenação motora fina, com Quociente Motor (QM) (QM1 = 100,47), motricidade global (QM2 = 100,42) e equilíbrio (QM3 = 98,07). Já a variável esquema corporal teve a classificação normal baixo (QM4 = 82,06). As menores classificações foram nas áreas de organização espacial (QM5 = 73,3) com classificação inferior, e a organização temporal, muito inferior (QM6 = 69,0). Na classificação geral dos escolares, 94% (n = 49) obtiveram níveis de desenvolvimento motor normal (médio e baixo). Um percentual de 4% (n = 2) foi classificado como inferior e 2% (n = 1), muito inferior. Conclui-se que o desenvolvimento motor da maioria dos escolares quilombolas encontra-se dentro dos parâmetros da normalidade.

Motor development is a sequence of evolutionary steps that occurs according to age group, and it develops by means of requirements in the interaction of the child with the task, biological individuality, and environment conditions. This study analyzed the motor performance of Quilombola students between 8 to 10 years. This quantitative search with cross-type survey has a sample of 52 students. The data collection instrument used was the Rosa Neto's test protocol Motor Development Scale (MDS). The selection of the sample was of intentional type. The variables fine motor coordination, with quotient motor (QM) (QM1 = 100.47), global drive (QM2 = 100.42) and equilibrium (QM3 = 98.07) showed normal average classification. On the other hand, the variable body scheme had normal low rating (QM4 = 82.06). The smallest classifications were found in the areas of spatial organization (QM5 = 73.3), with lower classification, and temporal organization was much lower (QM6 = 69.0). In the general classification of the students, 94% (n = 49) achieved normal motor development levels (medium and low). A total of 4% (n = 2) was classified as lower and 2% (n = 1) much lower. The motor development of most Quilombola students is within normality parameters.

El desarrollo motor es una secuencia evolutiva que se produce según el grupo de edad, determinado por los requerimientos de la interacción del niño con la tarea, la individualidad biológica y las condiciones del medio ambiente. El objetivo de este estudio fue analizar el desempeño motor de los escolares quilombolas entre 8 y 10 años de edad. Es una investigación cuantitativa de tipo transversal, con una muestra formada por 52 escolares. El instrumento de recolección de datos utilizado fue el protocolo de prueba de la Escala de desarrollo motor de Rosa Neto (EDM). La selección de la muestra fue del tipo intencional. Se presentaron como clasificación normal media las variables la coordinación motriz fina, con el cociente motor (QM) (QM1 = 100,47), la motricidad global (QM2 = 100,42) y el equilibrio (QM3 = 98,07). La variable esquema del cuerpo tuvo la clasificación normal baja (QM4 = 82,06). Las menores clasificaciones estaban en las áreas de la organización espacial (QM5 = 73,3), con la clasificación inferior, y la organización temporal, mucho inferior (QM6 = 69,0). En la clasificación general de los escolares, el 94% (n = 49) obtuvieron niveles normales de desarrollo motor (medio y bajo). Un 4% (n = 2) se clasificó como inferior; y un 2% (n = 1), mucho inferior. Se concluye que el desarrollo motor de la mayoría de los escolares quilombolas se encuentra bajo los estándares de normalidad.

Low-intensity laser (660 NM) has analgesic effects on sternotomy of patients who underwent coronary artery bypass grafts.

BACKGROUND: The aim of this study was to evaluate the efficacy of low-level laser therapy for reducing the acute pain of sternotomy in patients who underwent a coronary artery bypass graft (CABG). METHODS: This study was conducted with ninety volunteers who electively submitted to CABG. The volunteers were randomly allocated into three groups of equal size (n = 30): control, placebo, and laser (λ of 660 nm and spatial average energy fluency of 1.06 J/cm 2 ). Pain when coughing was assessed by a visual analog scale (VAS) and McGill Pain Questionnaire, according to sensory, affective, evaluative, and miscellaneous domains. The patients were followed for 1 month after the surgery. RESULTS: The laser group had a greater decrease in pain with analogous results, as indicated by both the VAS and the McGill questionnaire (P ≤ 0.05) on sensory and affective scores, on days 6 and 8 postsurgery compared to the placebo and control groups. CONCLUSION: Laser seems to be effective promoting pain reduction after coronary-arterial bypass grafting.

Photobiomodulation (Laser and LED) on Sternotomy Healing in Hyperglycemic and Normoglycemic Patients Who Underwent Coronary Bypass Surgery with Internal Mammary Artery Grafts: A Randomized, Double-Blind Study with Follow-Up.

BACKGROUND AND OBJECTIVE: This study aimed at analyzing the healing effects of low-level laser therapy (LLLT) (λ620 nm, 6 J/cm2) and light-emitting diode (LED) therapy (λ640 nm, 6 J/cm2) on the longitudinal sternotomy incisions of hyperglycemic and normoglycemic patients who underwent coronary artery bypass grafting (CABG). MATERIALS AND METHODS: 120 volunteers were electively submitted to CABG and were randomly allocated into four different groups of equal size (n = 30): control, placebo, laser (λ of 640 nm and spatial average energy fluency [SAEF] of 1.06 J/cm2), and LED (λ of 660 ± 20 nm and SAEF of 0.24 J/cm2). Laser and LED groups were irradiated from the second to eighth day postsurgery, and sternotomy incision was photographically registered. Then, participants were also separated into hyperglycemic and normoglycemic groups, according to their fasting blood glucose test before surgery. Three researchers blindly analyzed the incision photographs to determine hyperemia and wound closure at the first day of hospital discharge (eighth postoperative day). RESULTS: LLLT and LED groups had similarly less hyperemia and less incision bleeding or dehiscence (p ≤ 0.005) and the outcomes were also analogous between hyperglycemic and normoglycemic patients, which indicates no difference observed in an intragroup analysis (p ≥ 0.05). CONCLUSIONS: With the present therapy parameters, it may be assumed that both coherent light (laser) and non-coherent light (LED) are effective in promoting sternotomy and healing acceleration, which are evident on the eighth day postsurgery.

Low-intensity laser (660 nm) on sternotomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study.

The aim of this study was to analyze the healing effects of low-level laser therapy (LLLT) on the longitudinal sternotomy incisions of patients who underwent coronary artery bypass graft (CABG). The volunteers were randomized into three groups of equal size (n = 30): control, placebo, and laser (λ = 660 nm and spatial average energy fluency [SAEF] = 1.06 J/cm2). The patients in the laser group underwent irradiation on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were photographed immediately after the surgery and 8 days later for analysis. Three researchers who were blinded to the patient treatment groups analyzed the incision photographs to assess hyperemia and wound closure on the day of hospital discharge (eighth postoperative day). The sternotomy incisions in the LLLT group demonstrated less hyperemia, incisional bleeding, and dehiscence (p ≤ 0.005).

Low-Level Laser and Light-Emitting Diode Therapy for Pain Control in Hyperglycemic and Normoglycemic Patients Who Underwent Coronary Bypass Surgery with Internal Mammary Artery Grafts: A Randomized, Double-Blind Study with Follow-Up.

OBJECTIVE: This study aimed to evaluate the efficacy of low-level laser therapy (LLLT) and light-emitting diodes (LEDs) for reducing pain in hyperglycemic and normoglycemic patients who underwent coronary artery bypass surgery with internal mammary artery grafts. METHODS: This study was conducted on 120 volunteers who underwent elective coronary artery bypass graft (CABG) surgery. The volunteers were randomly allocated to four different groups of equal size (n = 30): control, placebo, LLLT [λ = 640 nm and spatial average energy fluence (SAEF) = 1.06 J/cm(2)], and LED (λ = 660 ± 20 nm and SAEF = 0.24 J/cm(2)). Participants were also divided into hyperglycemic and normoglycemic subgroups, according to their fasting blood glucose test result before surgery. The outcome assessed was pain during coughing by a visual analog scale (VAS) and the McGill Pain Questionnaire. RESULTS: The patients were followed for 1 month after the surgery. The LLLT and LED groups showed a greater decrease in pain, with similar results, as indicated by both the VAS and the McGill questionnaire (p ≤ 0.05), on the 6th and 8th postoperative day compared with the placebo and control groups. The outcomes were also similar between hyperglycemic and normoglycemic patients. One month after the surgery, almost no individual reported pain during coughing. CONCLUSIONS: LLLT and LED had similar analgesic effects in hyperglycemic and normoglycemic patients, better than placebo and control groups.

The effects of LED emissions on sternotomy incision repair after myocardial revascularization: a randomized double-blind study with follow-up.

This study aimed to analyze the effects of light-emitting diode (LED) therapy on sternotomy pain and healing in patients who underwent coronary artery bypass grafting (CABG). The patients were followed for 6 months after the surgery to determine their dehiscence. This study was conducted with 90 volunteers who electively submitted to CABG. The volunteers were randomly allocated into three different groups of equal size: LED (λ of 640 ± 20 nm and spatial average energy fluency of 1.2 J/cm(2) during hospitalization), placebo, or control. The outcomes assessed were pain when coughing by a visual analog scale (VAS) and the McGill questionnaire and sternotomy healing by clinical assessment and photographical register end interpretation. The LED group had better pain reduction, as indicated by both the VAS and the McGill questionnaire (number of words chosen and pain index) (p ≤ 0.05), on days 6 and 8 after hospital discharge compared to the placebo and control groups. One month after surgery, almost no individual mentioned pain when coughing. Three researchers blindly analyzed the incision photographs to determine hyperemia and wound closure, and they found that the LED group had both less hyperemia and less incision bleeding or dehiscence. The LED therapy (640 nm) had an analgesic effect on the sternotomies of patients who underwent CABG, increasing their incision healing and preventing dehiscence.

A estimulação elétrica nervosa do nervo tibial posterior no tratamento de pacientes com incontinência urinária: uma revisão de literatura / Electrical nerve stimulation posterior tibial nerve in the treatment of patients with urinary incontinence: a review of literature

A incontinência urinária é um problema de saúde pública e tem alta prevalência entre as mulheres. Os sintomas decorrentes dessa afecção afetam a qualidade de vida dos pacientes em suas implicações sociais, físicas e sexuais, justificando assim a importância desse estudo, que se trata de um levantamento bibliográfico sobre a estimulação elétrica do nervo tibial no tratamento dos sintomas miccionais. O objetivo da pesquisa foi analisar as evidências científicas da terapia, seu mecanismo e benefícios no tratamento da incontinência urinária, incluindo a melhoria da qualidade de vida e dos sintomas. Após a análise de 12 estudos, foram observados dados que incluem o número de participantes, a intervenção, a técnica realizada, os métodos de avaliação e a eficácia da técnica comparada ou não a estudos com placebo. A estimulação elétrica do nervo tibial posterior é uma terapia relativamente recente no tratamento da incontinência, já utilizada em ambiente clínico por fisioterapeutas. Conclui-se por meio da analise dos estudos que a terapia é eficaz e pode melhorar os sintomas e trazer benefícios para a qualidade de vida dos pacientes...

Urinary incontinence is a public health problem and has a high prevalence among women. Symptoms resulting from this condition affect the quality of life of patients in their social, physical and sexual implications, thus justifying the importance of this study that is a literature on electrical stimulation of the tibial nerve in the treatment of LUTS. The objective of the research was to analyze the scientific evidence of the therapy, its mechanism and benefits in the treatment of urinary incontinence, including improved quality of life and symptoms. After analyzing 12 studies were observed data that include the number of participants,the intervention, the technique used, the assessment methods and the effectiveness of the technique or not compared to studies with placebo. Electrical stimulation of the posterior tibial nerve is a relatively new therapy in the treatment of incontinence, already used in the clinical setting by physiotherapists. We conclude by analyzing the studies that the therapy is effective and can improve symptoms and bring benefits to the quality of life of patients...

Low-intensity laser therapy and led (light emitting diode) therapy in mechanical resistance of Rattus norvegicus chest inscision with implant of steel wire for sternal suture

INTRODUCTION: Low-intensity laser (LILT) and LED therapy are indicated in repairing surgical incisions, which occur in cardiac surgery. One major concern in this case is the presence of metallic wire used for sternal sutures, its temperature may rise while using a laser or LED. This study aimed to analyze the tensiometric properties of the skin tissue with longitudinal incision and metallic wire implant used for sternal suture irradiated with LILT and LED. METHODS: Twenty-five subjects (Rattus norvegicus) were submitted to thoracic incision with implantation of metallic wire, and subsequently divided into five groups: GI (control group); GII (laser group 6J/cm²); GIII (laser group 10J/cm²); GIV (LED group 6 J/cm²); and GV (LED 10J/cm²). Photobiomodulation was performed on a daily basis for eight consecutive days and the local temperature was measured before and after phototherapy. After euthanasia the tissues were subjected to tensiometric and histological analysis. RESULTS: All irradiated groups showed increase in break strength (p = 0.009), and decrease in tissue deformation strength compared with the control group (p = 0.03). CONCLUSION: Both LILT and LED can promote wound healing at the tested doses with increased tissue resistance, although its elasticity is reduced. The imprecision of the assessing instruments precluded an accurate measurement of a possible local tissue heating post irradiation and future studies are need to elucidate this effect.

Diástase dos músculos retos abdominais em puérperas na fase hospitalar / Diastasis of the rectus abdominis muscle in puerperium during hospitalization period

Introdução: Uma diástase do músculo reto abdominal (DMRA) de 3 cm ou mais em puérperas é considerada acima dos padrões de normalidade e poderão trazer maiores complicações como dores lombares, limitações funcionais e herniações das vísceras abdominais. Objetivo: Mensurar a DMRA em puérperas, na Maternidade do Hospital Satélite, e correlacionar com paridade, idade da puérpera, peso do recém nascido (RN) e sedentarismo. Material e métodos: Estudo transversal, observacional, com uma amostra de 30 puérperas, examinadas no mês de novembro de 2008 em relação à paridade, ao sedentarismo e ao peso do RN. Resultados: A multiparidade foi o que apresentou uma maior relação ao aumento de DMRA, quando comparada ao grupo primigestas/secundigestas (p = 0,003). A média da DMRA em sedentárias foi de 3,7 cm e para as não sedentárias foi de 2,8 cm (p < 0,05). O peso do RN tem influência de 11,47 por cento sobre a diástase (p < 0,067). A variável que mais evidenciou uma correlação positiva com o aumento da DMRA foi a faixa etária da gestante com influência de 42,99 por cento sobre DMRA (p < 0,008).Conclusão: A paridade, a prática de atividade física, o peso do RN e, principalmente, a idade da gestante influenciam diretamente na variação do tamanho da DMRA durante o período de gestação.

Introduction: A diastasis recti of the rectus abdominis muscle (RAMD) of 3 cm width or more is considered out of the acceptable patterns and can cause other commitments such as back pain, functional limitations and abdominal visceral herniation. Objective: To measure the RAM in post childbirth woman at the Maternity of Satélite Hospital in Teresina, Piauí, Brazil, and to correlate it to parity, mother’s age at delivery, newborn weight and sedentarism. Method: This was a transversal and observational study with 30 women examined at immediate post-partum on November 2008 in terms of parity, sedentarism and newborn weight. Results: High parity factor showed a higher relation to the diastase increase when was compared first pregnancy and second pregnancy group (p = 0.003). The average of RAMD in sedentary women was 3.7 cm comparing to 2.8 cm in non-sedentaries (p < 0.05). The newborn weight has 11.47 percent of influence over diastase (p < 0,067). The variable that most influenced with a positive correlation with RAMD was the mother age at delivery (42.99 percent over RAMD, p < 0.008). Conclusion: Parity, physical activity, newborn weight and, mainly, age of pregnant woman are factors that influence RAMD size range during pregnancy.