Factores asociados al nivel de dolor en la admisión y en el alta en víctimas de trauma / Fatores associados ao nível de dor na admissão e na alta em vítimas de trauma / Factors associated with level of pain in admission and high in victims of trauma

Introducción: Diferentes factores pueden estar asociados a la génesis y mantenimiento del cuadro de dolor en víctimas de trauma. La baja evaluación y el bajo tratamiento del dolor agudo en las unidades de urgencia han llevado a una atención descalificada, aumentando la morbilidad y el tiempo de internación. El objetivo de esta investigación fue verificar los factores asociados al nivel de dolor en la admisión y en el alta en víctimas de trauma. Metodología: Estudio transversal, realizado con 92 víctimas de trauma atendidas en una unidad de urgencia en el Sur de Brasil. La intensidad y ubicación del dolor fueron evaluadas, respectivamente, por medio de la escala numérica de dolor y diagrama corporal. Los datos fueron analizados con ayuda de la estadística no paramétrica. Resultados: Los hallazgos indicaron asociación del dolor más intenso en la admisión o en el alta a características como: sexo masculino, edad más joven, color de la piel no blanca, presencia de compañero, heridas ocasionadas por quemadura, presencia de prescripción medicamentosa, administración analgésica por vía endovenosa y tiempo superior a 30 minutos para mejora del dolor. Conclusión: La institución de protocolos o algoritmos de medición y tratamiento del dolor por los profesionales de salud en las unidades de urgencia debe considerar tales características a fin de prestar una asistencia resolutiva y de calidad (AU)

Introdução: Diferentes fatores podem estar associados à gênese e manutenção do quadro álgico em vítimas de trauma. A subavaliação e o subtratamento da dor aguda nas unidades emergenciais têm acarretado em um atendimento desqualificado, aumentando a morbidade e o tempo de internação. O objetivo desta investigação foi verificar os fatores associados ao nível de dor na admissão e na alta em vítimas de trauma. Metodologia: Estudo transversal, realizado com 92 vítimas de trauma atendidas em uma unidade emergencial no Sul do Brasil. A intensidade e localização da dor foram avaliadas, respectivamente, por meio da escala numérica de dor e diagrama corporal. Os dados foram analisados com o auxílio de estatística não paramétrica. Resultados: Os achados demonstraram que estiveram associadas à dor mais intensa na admissão ou na alta características como: sexo masculino, idade mais jovem, cor da pele não branca, presença de companheiro, lesões do tipo queimadura, presença de prescrição medicamentosa, administração analgésica por via endovenosa e tempo superior a 30 minutos para melhora da dor com a farmacoterapia. Conclusão: A instituição de protocolos ou algoritmos de mensuração e tratamento da dor pelos profissionais de saúde nas unidades emergenciais deve considerar tais características a fim de se prestar uma assistência resolutiva e de qualidade (AU)

Introduction: Different factors may be associated with the genesis and maintenance of pain symptoms in trauma. the underevaluation and undertreatment of acute pain in emergency units have called in an unqualified care, increasing morbidity and length of hospital stay. the objective of this investigation was to determine the factors associated with the level of pain on admission and at discharge in trauma. Methodology: Cross-sectional study with 92 trauma victims treated at an emergency unit in southern Brazil. the intensity and location of pain were assessed, respectively, through the numerical pain scale and body diagram. data were analyzed with the aid of non-parametric statistics. Results: The results showed that were associated with more severe pain on admission or discharge characteristics like being male, younger age, non-white skin color, companion presence, burn-like lesions, presence of drug prescription, analgesic administration intravenously and longer than 30 minutes for pain relief with pharmacotherapy. Conclusion: The imposition of protocols or algorithms of measurement and treatment of pain by health professionals in emergency units should consider these characteristics in order to provide a resolutive and quality care (AU)

Survey on the use of health services by adult men: prevalence rates and associated factors.

OBJECTIVE: estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. METHOD: population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. RESULTS: the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. CONCLUSION: the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found.

Evaluation of the care program implementation to people with high blood pressure.

OBJECTIVE: to evaluate the implementation of the care program for people with hypertension in Maringá-PR. METHOD: it is an evaluative research of cross-sectional design. Data were collected through structured interviews with 63 nurses between April and June 2013. RESULTS: as missing or insufficient, there were: transportation for outside activities; work equipment; educational materials; training resources; inclusion of the family in the care plan; risk classification of individuals; determination of therapy from the risk classification and referral of the patient to medical and/or specialized tests. CONCLUSION: in addition to qualifying structure, there are: the need to identify people with hypertension as risk factors, perform risk stratification and systematic care planning, establishing an advanced clinical practice, such as support for self-care and management cases, accomplish with existing protocols and develop collective actions based on information systems.

Differences between genders in relation to factors associated with risk of diabetic foot in elderly persons: A cross-sectional trial.

AIMS: This trial aims to identify differences between genders in relation to factors associated with the risk of diabetic foot in elderly persons. METHODS: We evaluated 187 older adults diagnosed with diabetes type 2. The variables investigated were sociodemographic data, clinical history of diabetes mellitus and complaints about the feet. The plantar sensitivity was evaluated on both feet, with the use of Semmes-Weinstein monofilaments. For data analysis we used chi-square test and binary logistic regression (p < 0.05; 95% CI). RESULTS: We included 174 elderly people who had no history of stroke and peripheral vascular disease. Most (58.6%) were female and among them the risk factors for diabetic foot were older age (p < 0.021; OR 6.0), presence of calluses (p < 0.046; OR 2.83) and claw toes (p < 0.041; OR 3.18). And among men, the risk factors for diabetic foot were insulin use (p < 0.008; OR 5.22), presence of sensory comorbidities (p < 0.007; OR 5.0), ulcers (p < 0.001), numbness (p < 0.002; OR 6.6) and stiffness in the feet (p < 0.009; OR 5.44). CONCLUSION: The factors associated with the development of diabetic foot were presented differently in women and men, so a targeted and more specific preventive approach is required.

AIDS epidemic in the triple frontier: subsidies for professional practice.

OBJECTIVE: to analyze the AIDS epidemic trend from 1988 to 2012, in a tri-border area. METHOD: Ecological time-series study with data from the Department of informatics from the Brazilian Unified Health System (SUS). RESULTS: A total of 1427 cases of AIDS were registered, and 82.1% were aged 20-49 years and 56% in males. The relationship man/woman went from 9/1 to 1/1 and increased the number of cases among individuals with more years of education, also, people aged more than 50 years old the age group from 20 to 34 years old. The most common exposure category was heterosexual, significantly higher among women; on the other hand, drug injection use was associated with male gender. CONCLUSION: seeking to embrace the changes in the epidemiological scenario of AIDS, nursing professionals should implement intervention strategies for people identified as the most vulnerable to HIV infection.

Effectiveness of individual and group interventions for people with type 2 diabetes.

OBJECTIVE: to compare the effectiveness of two educational interventions used by a healthcare provider in the monitoring of individuals with type 2 diabetes mellitus (T2DM), regarding knowledge of the disease, impact on quality of life and adoption of self-care actions. METHODS: comparative, longitudinal, prospective study performed with 150 subjects with type 2 diabetes, analyzed according to the type of participation in the program (individual and/or group). Participants of the individual intervention (II) received nursing consultations every six months and those of the group intervention (GI) took part in weekly meetings for three months. Data were collected through four questionnaires: Identification questionnaire, Problem Areas in Diabetes Questionnaire (PAID), Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the Diabetes Knowledge Scale (DKN-A). Data were analyzed using the Friedman and Mann Whitney tests, considering a statistical significance of p ≤ 0.05. RESULTS: there was an increase in knowledge about the disease in the II (p<0.003) and GI (p<0.007), with reduction of the impact on the quality of life in the II (p<0.007) and improvement in self-care actions in the GI (p<0.001). CONCLUSION: in both intervention models improvements were observed in the indicators, over the six month monitoring period.

Microvascular complications in type 2 diabetes and associated factors: a telephone survey of self-reported morbidity.

The scope of this article is to estimate the prevalence of microvascular complications of self-reported type 2 diabetes and the association with sociodemographic characteristics, nutritional status, treatment given and time since diagnosis. It involved a cross-sectional study with 318 people with type 2 diabetes living in Maringá in the State of Paraná. A telephone survey of self-reported morbidity was conducted in the months from January to June 2012. For the analysis descriptive statistics, univariate and multiple logistic regression were used. The prevalence of self-reported complications of diabetes was 53.8%, the most frequent being retinopathy (42.8%), followed by peripheral neuropathy (14.5%) and nephropathy (12.9%). The variables associated with the presence of complications were age (p = 0.008), overweight/obesity (p = 0.002), insulin (p < 0.001), insulin use linked to oral antidiabetic drug (p = 0.003) and time since diagnosis (p = 0.013). The prevalence of self-reported microvascular complications for people with diabetes was high, being more frequent among those of more advanced age, with inadequate nutritional status, a delay in diagnosis of the disease and those who were using insulin alone or in combination with oral antidiabetic agents.

Representations and uses of medicinal plants in elderly men.

The aim of this study was to know and understand the representations and use of medicinal plants by elderly men assisted in the Family Health Strategies of Dourados, MS. Participated in this study, 18 elderly men aged over 60 years, using four or more medications. The research was conducted with qualitative approach. The results showed that there is still the consumption of medicinal plants among the elderly, especially in the treatment of minor harm. The representations about the plants seem anchored in the concept of safety; they are natural and few side effects. Its use is made concurrently with the manufactured medicines without regard to risk of interactions. Older men use medicinal plants, without however reporting to health professionals. Therefore, it is necessary continuing education focused on phytotherapy health team and nursing, contributing to safe and effective use of medicinal plants.

[Drug utilization in renal transplant patients: medication practices and representations]. / Uso de medicamentos em transplantados renais: práticas de medicaçao e representações.

Qualitative research approach, descriptive and exploratory with objective of to know the practices and representations of medication on the use of drugs by people transplanted kidney. 18 people participated in the Dourados (MS), through semistructured interview. The theoretical contributions of medication practices were Peter Conrad and representation of Stuart Hall. The definition of the categories of theoretical analysis was Michel Foucault. Respondents had a mean age of 53.5 years, 13 males and 5 females, with median time to transplant eight years. The medications predominantly used were immunosuppresssive. We developed three categories of analysis: the drug as part of everyday life, the central role of the drug and correlation with rejection, and medicine and the autonomy of the transplanted kidney. The drugs are part of everyday life and the representations of autonomy and quality enhance your daily use.