Subject(s)
COVID-19 , Neoplasms , Brazil/epidemiology , Healthcare Disparities , Humans , Neoplasms/epidemiology , SARS-CoV-2ABSTRACT
COVID-19 in children and adolescents has low frequency, severity, and fatality rate all over the world. A cross-sectional study was conducted to assess the epidemiological and clinical aspects of COVID-19 in patients younger than 20 years in Pernambuco (Brazil), with cases confirmed by reverse-transcriptase-PCR SARS-CoV-2 between 13 February and June 19, 2020, reported on information systems. Data regarding age (< 30 days, 1-11 months, 1-4 years, 5-9 years, 10-14 years, and 15-19 years), gender, color/race, symptoms, pregnancy or puerperium, comorbidities, hospitalization, and death were investigated. Fatality rate and mortality coefficient were calculated, and a multiple logistic regression analysis was performed to determine if gender, age, and comorbidities were factors associated with death. Of 682 pediatric cases, 52.8% were female, with a mean age of 9 ± 7.2 years. The most frequent symptoms were fever (64.4%), cough (52.4%), and respiratory distress (32.4%). Hospitalization was reported in 46.2% of cases, mainly among neonates (80.3%) and infants (73.8%). Thirty-eight deaths were notified, and a fatality rate of 5.6% (95% CI: 3.9-7.3) was found, with higher fatality rates among neonates 11.5% (7 of 61) and 9.5% (8 of 84) infants. The mortality coefficient was 10.9 per 100,000 inhabitants < 1 year of age, whereas comorbidities (Odds ratio [OR] = 14.13, 95% CI: 6.35-31.44), age < 30 days (OR = 5.17, 95% CI: 1.81-14.77), and age 1-11 months (OR = 3.28, 95% CI: 1.21-8.91) were independent factors associated with death. The results demonstrate the vulnerability of neonates and infants with severe conditions, need hospitalization, and high fatality rate, indicating the necessity to adapt public health policies for these age-groups.
Subject(s)
COVID-19/mortality , SARS-CoV-2 , Adolescent , Age Factors , Brazil/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Young AdultABSTRACT
Abstract Objectives: Considering the lack of questionnaires that propose to evaluate parental satisfaction with the Neonatal Intensive Care Unit (NICU) in Brazil, this study aimed to carry out the translation of the EMPATHIC-N questionnaire into Brazilian Portuguese, the cross-cultural adaptation and validation of its contents. Method: The translation and cultural adaptation of the questionnaire was carried out according to the protocol established by the Translation and Cross-Cultural Adaptation Group of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in 2005. The validation of the content was carried out by a panel of experts, who evaluated each item from "very irrelevant" to "very relevant". Items with a mean Likert scale value <3.5 were excluded. Cronbach's alpha of the domains was calculated. Results: The questionnaire was submitted to two pilot tests with mothers of newborns admitted to the NICU of the study, after which some terms were modified to achieve global understanding. Cronbach's alpha remained above 0.7 in all items. Conclusion: The tool resulting from the translation, cultural adaptation, and validation of the EMPATHIC-N questionnaire showed to be adequate to assess satisfaction of parents of newborns admitted to the NICU in Brazil.
Resumo Objetivos: Considerando a ausência de questionários que se proponham a avaliar satisfação de pais em Unidade de Cuidados Intensivos Neonatal (UCIN) no Brasil, o presente estudo teve o objetivo de fazer a tradução do questionário Empowerment of Parents in the Intensive Care- Neonatology (Empathic-N) para o português brasileiro, adaptação transcultural e validação de seu conteúdo. Método: Foi feita tradução e adaptação transcultural do questionário, segundo protocolo estabelecido pelo Grupo da Tradução e Adaptação Transcultural da Sociedade Internacional para Pesquisas Farmacoeconômicas (Ispor) em 2005. A validação do conteúdo foi feita por um comitê de especialistas, que avaliaram cada item de “muito irrelevante” a “muito relevante”. Foram excluídos os itens com média da Escala Likert menor do que 3,5. Foi calculado alfa de Cronbach dos domínios. Resultados: Na tradução foi invertida a ordem de algumas frases de acordo com a sintaxe do português brasileiro e alterado o tempo verbal para terceira pessoa do pretérito imperfeito. A maior parte das afirmativas manteve o sentido com a retradução, as diferenças foram atribuídas ao uso de sinônimos pelos dois tradutores. Foi submetido a dois testes-piloto com mães de recém-nascidos internados na UCIN do estudo, modificaram-se alguns termos até se atingir compreensão global. O alfa de Cronbach permaneceu acima de 0,7 em todos os itens. Conclusão: O instrumento resultante da tradução, adaptação transcultural e validação do Empathic-N mostra-se adequado para avaliar satisfação dos pais de recém-nascidos internados em UCIN no Brasil.
Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Parents/psychology , Power, Psychological , Intensive Care Units, Pediatric , Cross-Cultural Comparison , Surveys and Questionnaires , Patient Satisfaction , Translations , Brazil , NeonatologyABSTRACT
OBJECTIVES: Considering the lack of questionnaires that propose to evaluate parental satisfaction with the Neonatal Intensive Care Unit (NICU) in Brazil, this study aimed to carry out the translation of the EMPATHIC-N questionnaire into Brazilian Portuguese, the cross-cultural adaptation and validation of its contents. METHOD: The translation and cultural adaptation of the questionnaire was carried out according to the protocol established by the Translation and Cross-Cultural Adaptation Group of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in 2005. The validation of the content was carried out by a panel of experts, who evaluated each item from "very irrelevant" to "very relevant". Items with a mean Likert scale value <3.5 were excluded. Cronbach's alpha of the domains was calculated. RESULTS: The questionnaire was submitted to two pilot tests with mothers of newborns admitted to the NICU of the study, after which some terms were modified to achieve global understanding. Cronbach's alpha remained above 0.7 in all items. CONCLUSION: The tool resulting from the translation, cultural adaptation, and validation of the EMPATHIC-N questionnaire showed to be adequate to assess satisfaction of parents of newborns admitted to the NICU in Brazil.
Subject(s)
Cross-Cultural Comparison , Intensive Care Units, Pediatric , Parents/psychology , Patient Satisfaction , Power, Psychological , Surveys and Questionnaires , Translations , Adolescent , Adult , Brazil , Female , Humans , Male , Neonatology , PregnancyABSTRACT
Modelo do estudo: estudo de caso. Objetivo: analisar a Rede de Atenção às Urgências sob a ótica do Serviço de Atendimento Móvel de Urgência (SAMU) Metropolitano do Recife. Material e Método: estudo de caso com múltiplas unidades de análise. O caso foi o SAMU Metropolitano do Recife e as unidades de análise foram os componentes: promoção, prevenção à saúde e vigilância; organização e governança da rede. Optou-se pela triangulação de métodos e de fontes, utilizando entrevista semiestruturada com 57 profissionais que atuavam nesse serviço; observação direta e documentos oficiais (banco de dados, portarias e relatórios). Para a análise dos dados qualitativos utilizou-se a técnica de condensação de significados e para os quantitativos, a frequência média dos eventos. Resultados: O perfil dos profissionais entrevistados mostra que 53% era do sexo masculino, 65% graduados há menos de 12 anos, um pouco mais da metade atuava no SAMU há menos de 2 anos e 77% tinham vínculo empregatício temporários por meio de contratos com as prefeituras. Segundo os entrevistados há estratégias de promoção e prevenção, mas, não conseguem visualizar mudanças no perfil epidemiológico e demográfico como resultado da implantação dessas estratégias. Existe uma distribuição inadequada dos equipamentos de saúde; baixa cobertura populacional dos pontos de atenção à saúde (50% de cobertura de PSF/ESF e déficit de 3.089 leitos hospitalares do SUS) e, falta de coordenação do comitê gestor estadual regional do sistema de atenção as urgências pela Secretaria do Estado de Pernambuco...
Study design: a case study. Objective: To analyze the Emergency Care Network from the perspective of the Mobile Emergency Care Service of the Metropolitan Recife (SAMU). Material and Method: a case study with multiple units of analysis. The object of the study was the SAMU and the units of analysis were the components: promotion, prevention and health surveillance; organization and governance of the network. We opted for the triangulation of methods and sources, using semistructured interviews with 57 professionals working in this service; direct observation and official documents (database, ordinances and reports). For the analysis of qualitative data we used the technique of condensing meanings and quantitative, the average frequency of events. Results: The profile of the professionals interviewed shows that 53% were male, 65%, had graduated less than 12 years, a little more than half worked in the SAMU for less than 2 years and 77% had temporary employment through contracts with the municipalities. According to the interviewees there are strategies of promotion and prevention, but one cannot see changes in the epidemiological and demographic profile as a result of the implementation of these strategies.There is an inadequate distribution of health equipment; low health coverage of the population (50% of PSF coverage / ESF and deficit of 3,089 hospital beds) and lack of coordination between the state regional steering committee of the care system emergencies...
Subject(s)
Humans , Male , Female , Ambulances , Emergency Medical Services , Emergency Medical System , Emergency Relief , Emergency TreatmentABSTRACT
OBJECTIVES: This study aimed to analyze some variables found in the Birth Certificates at the Instituto Materno Infantil de Pernambuco, Recife, from July 1991 to December 2000, according to Sinasc (National Information's data base of Births). METHODS: The statistical analysis was performed using the chi-square test for trend (p<0.05) on EpiInfo software (version 6.0), considering the years 1993 to 2000. RESULTS: The sample comprised a predominance of non-surgical deliveries, adequate gestational age of newborns, weight > 2500 g, Apgar score 1st min and 5th min between 8-10 and mature mothers who had attended from 4 to 6 appointments at prenatal care system. It showed the following rates: cesarean-section of 29.4% to 35.2% (chi2 = 73.7; p<0.01), low weight at birth of 15.9% to 22.8% (chi2 = 170.6; p < 0.01); premature newborns of 9.7% to 23.8% (chi2 = 503.6; p<0.01); teenage mothers of 24.1% to 28.8% (chi2 = 13.3; p<0.01), moreover a high percentage of newborns with Apgar index lower than 3 at the 1st minute (3.4% to 5.%) and (0.7% to 1.6%) at the 5th minute. CONCLUSION: These results confirm the role of IMIP as an institution for referral of high-risk pregnancies in Pernambuco.
Subject(s)
Birth Rate , Information Systems , Live Birth/epidemiology , Registries/statistics & numerical data , Birth Certificates , Brazil/epidemiology , Chi-Square Distribution , Female , Humans , Infant, Newborn , Male , Maternal-Child Health Centers/statistics & numerical data , PregnancyABSTRACT
OBJETIVO: Analisar a série temporal dos Nascidos Vivos do Instituto Materno Infantil de Pernambuco (IMIP) - Recife, segundo algumas variáveis, no período de julho de 1991 a dezembro de 2000. MÉTODOS: Utilizou-se o banco de dados do Sistema de Informação sobre Nascidos Vivos (Sinasc). Para análise estatística considerou-se os anos de 1993 a 2000 e foi realizado o Qui-quadrado de tendência (p < 0,05) no Epi Info (versão 6.0). RESULTADOS: Apesar da predominância de parto vaginal, peso > 2500g, idade gestacional > 37 semanas, Apgar no 1° e 5° minutos entre 8 e 10, mães adultas, 4 a 6 consultas de pré-natal, encontrou-se percentuais elevados e tendência progressiva na década para: partos cesarianos (29,4 por cento a 35,2 por cento, chi2 = 73,7; p < 0,01); baixo peso (15,9 por cento a 22,8 por cento, chi2 = 170,6; p < 0,01); pré-termos (9,7 por cento a 23,8 por cento, chi2 = 503,6; p < 0,001); mães adolescentes (24,1 por cento a 28,8 por cento, chi ² = 13,3; p < 0,01) além de um alto percentual de bebês com índice de Apgar menor que 3 no 1° minuto de 3,4 por cento a 5,5 por cento e no 5° minuto de 0,7 por cento a 1,6 por cento). CONCLUSÕES: Os resultados ratificam a caracterização do IMIP como hospital de complexidade terciária e de referência para gestantes e recém-nascidos de alto risco no Estado de Pernambuco.
Subject(s)
Female , Humans , Infant, Newborn , Male , Pregnancy , Birth Rate , Information Systems , Live Birth/epidemiology , Registries/statistics & numerical data , Birth Certificates , Brazil/epidemiology , Chi-Square Distribution , Maternal-Child Health Centers/statistics & numerical dataABSTRACT
Objetivo: avaliar, a partir do óbito infantil, o acesso e a qualidade da atenção Ó saúde prestada as crianças no município, durante a doença que levou ao óbito. Métodos: estudo descritivo de corte transversal, censitário, desérie de casos de óbitos infantis ocorridos em Bom Conselho, Pemambuco, no período de 1/1/1999 a 31/12/1999, identificados atravÚs do Sistema de Informação sobre Mortalidade, unidades de saúde, cartórios, cemitérios, agentes de saúde e parteiras. Os dados foram coletados mediante entrevistas domiciliares e revisÒo deprontußrios, em instrumentos específicos. Resultados: foram investigados 71 dos 72 óbitos identificados,com perda de 1,4por cento. A maioria (69,4por cento) ocorreu no periodo pós-neonatal. Do total, 67,6por cento aconteceram no domicilio, 77,5por cento procuraram assistÛncia pelo menos uma vez, sendo as emergências as mais procuradas (65,1por cento), porém 22,5 por cento não foram levados a nenhum serviço de saúde. A maioria dos serviços de saúde (90,9por cento ) estava a menos de uma hora de distância dos domiclios, 78,5por cento, localizados no município de residência, e 97 por cento dos atendimentos foram realizados por mÚdicos. Das 88 consultas realizadas, 39,8por cento terminaram com intemamento, e 27,3por cento foram atendidos e dispensados sem marcação da consulta de retomo, e 84 por cento receberam todas as medicaçÕes gratuitamente. Conclusões: através da vigilância dos óbitos, foi possível...
Subject(s)
Humans , Male , Female , Infant , Outcome and Process Assessment, Health Care , Quality Assurance, Health Care , Quality Indicators, Health CareABSTRACT
OBJECTIVE: To evaluate the access to and quality of health care administered to infants based on postmortem data. METHODS: A descriptive cross-sectional census-based study was carried out to assess the infant deaths that occurred in the town of Bom Conselho, state of Pernambuco, between January 1st 1999 and December 31st 1999. Home interviews and inspection of medical records were used for data collection. Deaths were identified by consulting the Mortality Information System, health centers, public notary services, cemeteries, health workers, and midwives. RESULTS: Seventy-one of 72 deaths were investigated, with a loss of 1.4%. The majority (69.4%) of deaths occurred in the postneonatal period and 67.6% of them occurred at home. In 77.5% of the cases medical help was sought at least once, most frequently at emergency units (65.1%). However, 22.5% of the patients were not taken to any kind of health care service. Most health care services (90.9%) were less than one hour away from the patient's home, 78.5% were located in the town of residence and 97% of the consultations were carried out by doctors. Of 88 consultations, 39.8% resulted in hospitalization and 27.3% in discharge without arrangement of a follow-up appointment. In 84% of the cases the medication was provided free of charge. CONCLUSIONS: Death surveillance revealed restricted access to medical care and poor quality of health care administered to infants living in the referred town. The high rate of home deaths is related to access, whilst the journeys made by some of the mothers to health care units, during the illness that caused the death of their infants, points to the precarious organization of those services.
