Percepção, conhecimento e satisfação do paciente em relação ao processo vacinal: revisão integrativa / Perception, knowledge and satisfaction of patients in relation to the vaccination process: an integrative review / Percepción, conocimiento y satisfacción del paciente en relación con el proceso de vacunación: revisión integradora

Objetivo: Analisar as evidências cientificas disponíveis na literatura acerca da percepção, o conhecimento e a satisfação do paciente em relação ao processo vacinal mediante a assistência recebida. Metodologia: Foi feita uma busca das referências nas bases PubMed, Scientific Electronic Library Online (SciELO) e Biblioteca Virtual em Saúde (BVS). Resultados: A busca permitiu a identificação de quatro estudos com os descritores de Vaccination AND Patient Care AND Perception, sete com os descritores Vaccination AND Patient Care AND Knowledge e um com os descritores Vaccination AND Patient Care AND Satisfaction. Considerações finais: Os estudos evidenciaram que o foco principal das pesquisas se enquadrou nos grupos de pais devido os mesmos acompanharem seus filhos no processo vacinal, gestantes, puérperas e pessoas com comorbidades. Constatou-se que houve maior declínio em relação a vacina influenza com as gestantes e HPV entrevistando pais. Os principais motivos de atraso e da não aceitação vacinal foi o desconhecimento vacinal, crença excessiva na imunidade natural, julgar que as vacinas são desnecessárias, medo das reações adversas e pouca satisfação quanto as informações recebidas. Quanto as possíveis lacunas na assistência o principal foi a carência de orientações ofertadas pelos profissionais da saúde, sendo assim, para que o repasse de informações aos pacientes seja efetivo e esses tenham melhores conhecimentos é de extrema importância que os profissionais da saúde estejam sempre atualizados, qualificando assim o repasse de informação, promovendo orientações de forma mais clara e consequentemente absorção de mais conhecimentos pelos usuários.

Objective: To analyze the scientific evidence available in the literature about the perception, knowledge and patient satisfaction regarding the vaccination process through the assistance received. Methodology: A search was performed for references in PubMed, Scientific Electronic Library Online (SciELO) and Virtual Health Library (BVS). Results: The search allowed the identification of four studies with the descriptors Vaccination AND Patient Care AND Perception, seven with the descriptors Vaccination AND Patient Care AND Knowledge and one with the descriptors Vaccination AND Patient Care AND Satisfaction. Final considerations: The studies showed that the main focus of the research was framed in the groups of parents because they accompany their children in the vaccination process, pregnant women, postpartum women and people with comorbidities. It was found that there was a greater decline in relation to influenza vaccine with pregnant women and HPV interviewing parents. The main reasons for delay and non-acceptance of the vaccine were lack of vaccine knowledge, excessive belief in natural immunity, judging that vaccines are unnecessary, fear of adverse reactions and little satisfaction with the information received. As for the possible gaps in care, the main one was the lack of guidelines offered by health professionals, so, for the transfer of information to patients to be effective and for them to have better knowledge, it is extremely important that health professionals are always up to date, thus qualifying the transfer of information, promoting clearer guidelines and consequently absorbing more knowledge by users.

Objetivo: Analizar la evidencia científica disponible en la literatura sobre la percepción, conocimiento y satisfacción del paciente en relación al proceso de vacunación a través de la atención recibida. Metodología: Se realizaron búsquedas de referencias en las bases de datos PubMed, Scientific Electronic Library Online (SciELO) y Virtual Health Library (BVS). Resultados: La búsqueda permitió la identificación de cuatro estudios con los descriptores de Vaccination AND Patient Care AND Perception, siete con los descriptores Vaccination AND Patient Care AND Knowledge y uno con los descriptores Vaccination AND Patient Care AND Satisfaction. Consideraciones finales: Los estudios mostraron que el foco principal de la investigación fue en los grupos de padres porque acompañan a sus hijos en el proceso de vacunación, embarazadas, puérperas y personas con comorbilidades. Se encontró que hubo una mayor disminución en relación con la vacuna contra la influenza con mujeres embarazadas y VPH entrevistando a los padres. Las principales razones para el retraso y la no aceptación de las vacunas fueron la falta de conocimiento de estas, la creencia excesiva en la inmunidad natural, juzgar que las vacunas son innecesarias, el miedo a las reacciones adversas y la poca satisfacción con la información recibida. En cuanto a las posibles brechas en la atención, la principal fue la falta de orientación ofrecida por los profesionales de la salud, para que la transferencia de información a los pacientes sea efectiva y tengan un mejor conocimiento, es extremadamente importante que los profesionales de la salud estén siempre actualizados, calificando así la transferencia de información, promoviendo la orientación más claramente y, en consecuencia, la absorción de más conocimiento por parte de los usuarios.

Assistência recebida durante a vacinação da Covid-19 em um município do noroeste do Paraná / Assistance received during Covid-19 vaccination in a northwestern municipality of Paraná / Asistencia recibida durante la vacunación con Covid-19 en un municipio del noroeste de Paraná

O presente estudo objetivou analisar a assistência recebida pelo usuário durante a vacinação da COVID-19 no município de Maringá-PR. Trata-se de um estudo descritivo, transversal, quantitativo, com amostra não probabilística por conveniência. A população correspondeu a pessoas maiores de 18 anos, que receberam a vacina contra COVID-19 em Maringá. A coleta dos dados foi realizada de maneira virtual, através do Google Forms, sendo o formulário composto por um questionário estruturado pelas pesquisadoras. A análise deu-se por estatística descritiva. A amostra final da pesquisa correspondeu a 217 participantes, predominando o sexo feminino (74,2%), idade de 18 a 28 anos (64,5%), sendo a maioria vacinada com três doses ou mais (51,6%), recebendo informações sobre a data e local de vacinação principalmente por redes sociais (67,3%). Identificaram-se mudanças de opiniões (31,8%), sendo essas positivas (24%) sobre a necessidade de manter as vacinas em dia. Verificou-se lacuna na assistência, sendo essa a falta de orientações sobre possíveis reações adversas dessa vacina (41,9%); entretanto, a grande parte dos pesquisados sentiram-se satisfeitos com a assistência vacinal recebida (48,4%) e consideraram de alta confiança os serviços prestados na sala de vacinação (43,8%). Conclui-se que a maioria dos participantes afirmaram satisfação com a assistência, porém identificaram-se lacunas na mesma, principalmente no ponto das orientações. Sendo assim, evidencia-se a necessidade de os próprios profissionais receberem capacitações que os conscientizem sobre a importância de melhores orientações, em especial visando a uma linguagem que seja compatível com cada comunidade e cultura, e assim as respeitando.

This study aimed to analyze the assistance received by the user during vaccination of COVID-19 in the municipality of Maringá-PR. This is a descriptive, cross- sectional, quantitative study, with a non-probability convenience sample. The population corresponded to people older than 18 years old, who received the COVID-19 vaccination in Maringá. Data collection was performed virtually, using Google Forms, and the form consisted of a questionnaire structured by the researchers. The analysis was done by descriptive statistics. The final sample corresponded to 217 participants, predominantly female (74.2%), aged 18 to 28 years (64.5%), and most of them had been vaccinated with three doses or more (51.6%), receiving information about the date and place of vaccination mainly through social networks (67.3%). Changes in opinions were identified (31.8%), which were positive (24%) about the need to keep the vaccines up to date. There was a gap in the assistance, which was the lack of guidance on possible adverse reactions to this vaccine (41.9%); however, the vast majority of respondents felt satisfied with the vaccination assistance received (48.4%) and considered highly reliable the services provided in the vaccination room (43.8%). It can be concluded that most participants were satisfied with the assistance, but gaps were identified, especially in the area of guidance. Thus, it is evident the need for the professionals themselves to receive training to make them aware of the importance of better guidance, especially aiming at a language that is compatible with each community and culture, and thus respecting them.

Este estudio tuvo como objetivo analizar la asistencia recibida por el usuario durante la vacunación de COVID-19 en el municipio de Maringá-PR. Se trata de un estudio descriptivo, transversal, cuantitativo, con muestra de conveniencia no probabilística. La población correspondió a personas mayores de 18 años, que recibieron la vacuna COVID-19 en Maringá. La recolección de datos se realizó de forma virtual, utilizando Google Forms, y el formulario consistió en un cuestionario estructurado por los investigadores. El análisis se realizó mediante estadística descriptiva. La muestra final correspondió a 217 participantes, predominantemente del sexo femenino (74,2%), con edad entre 18 y 28 años (64,5%), y la mayoría había sido vacunada con tres dosis o más (51,6%), recibiendo información sobre la fecha y lugar de vacunación principalmente a través de las redes sociales (67,3%). Se identificaron cambios de opinión (31,8%), que fueron positivos (24%) sobre la necesidad de mantener las vacunas al día. Hubo una carencia en la asistencia, que fue la falta de orientación sobre las posibles reacciones adversas a esta vacuna (41,9%); sin embargo, la gran mayoría de los encuestados se sintieron satisfechos con la asistencia de vacunación recibida (48,4%) y consideraron muy fiables los servicios prestados en la sala de vacunación (43,8%). Se puede concluir que la mayoría de los participantes estaban satisfechos con la asistencia, pero se identificaron lagunas, especialmente en el ámbito de la orientación. Así, se evidencia la necesidad de que los propios profesionales reciban formación para concienciarlos de la importancia de una mejor orientación, especialmente buscando un lenguaje compatible con cada comunidad y cultura, y así respetándolas.

Pro-inflammatory diet during pregnancy is associated with large-for-gestational-age infants.

A pro-inflammatory diet in pregnant women is associated with an increased risk of harmful maternal and fetal health outcomes. The present study aimed to investigate the relationship between the maternal energy-adjusted dietary inflammatory index (E-DII) and the classification of birth weight of newborns. We hypothesized that a maternal pro-inflammatory diet would be associated with a higher chance of inadequate birth weight infants. A prospective cohort study was conducted among 600 mother-infant pairs in Brazil. The E-DII was calculated through 24-hour dietary recalls on 2 occassions, using 36 of its 45 components. Secondary data on birth weight, sex of the newborns, and gestational age at birth were obtained. Adjusted logistic regression models were used to investigate the relationship between the maternal E-DII (in tertiles) and birth weight categories. The mothers' mean (standard deviation [SD]) age was 27 (5) years, 32.2% were overweight, and 21.5% had prepregnancy obesity. In total, 62 (10.3%) cases of small-for-gestational-age newborns and 79 (13.2%) of large-for-gestational-age (LGA) newborns were identified. The mean (SD) of the E-DII was 1.6 (1.5), ranging from -2.6 to 6.0. In adjusted logistic regression models, it was found that women classified in the third tertile of the E-DII had higher odds of having LGA infants (odds ratio, 2.07 [95% confidence interval, 1.07-4.02], P =.03), when compared with the women classified in the first tertile. A maternal pro-inflammatory diet was associated with a higher chance of LGA infants, reinforcing the relevance of the consumption of foods naturally rich in antioxidants during pregnancy.

A better quality of maternal dietary fat reduces the chance of large-for-gestational-age infants: A prospective cohort study.

OBJECTIVES: We sought to investigate the relationship between the usual intake of fatty acids and indices of dietary fat quality in pregnant women and the birth-weight categories of their newborns. METHODS: This prospective cohort study was conducted with 734 mother-infant pairs in Brazil. Dietary intake was estimated through 24-h dietary recalls. Secondary data on birth weight, sex of the newborn, and pregnancy duration were obtained. The relationship of fatty acids and indices with birth-weight categories were investigated using logistic regression models adjusted for confounding factors. We considered P values < 0.05 significant. RESULTS: The median (interquartile range) maternal age was 27 (23-31) y; 46.2% of the pregnant women had pregestational body mass index ≥ 25 kg/m2, 18.1% had gestational diabetes mellitus, and 11.2% had hypertension. Regarding the newborns, 68 (9.3%) were classified as small for gestational age, 545 (74.2%) as appropriate size for gestational age, and 121 (16.5%) as large for gestational age. In adjusted logistic regression models, a lower chance of being large for gestational age was observed among the children of women classified in the third tertile (versus the first tertile) for intake of polyunsaturated fatty acids (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.31-0.89; P = 0.02), ω-3 fatty acids (OR, 0.48; 95% CI, 0.28-0.80; P = 0.005), and ω-6 fatty acids (OR, 0.56; 95% CI, 0.33-0.96; P = 0.04) and for ratios of polyunsaturated to saturated fatty acids (OR, 0.54; 95% CI, 0.32-0.92; P = 0.03) and hypocholesterolemic to hypercholesterolemic fatty acids (OR, 0.51; 95% CI, 0.30-0.87; P = 0.01). CONCLUSIONS: The data suggest that better-quality fat in the maternal diet can reduce the chance of a large-for-gestational-age newborn.

Relationship between the quality of the pregnant woman's diet and birth weight: a prospective cohort study.

BACKGROUND: Birth weight is a relevant predictor of childhood health outcomes. Studies investigating the association between modifiable risk factors, as the maternal diet quality, and birth weight are needed. We aimed to investigate the association between the Diet Quality Index Adapted for Pregnant Women (IQDAG) score and birth weight. METHODS: This is a prospective cohort that includes 547 Brazilian mother-child pairs. Dietary recalls and a food frequency questionnaire were obtained during pregnancy. Information on birth weight, sex, and gestation duration were obtained from the Live Birth Information System (SINASC). RESULTS: On total, 3.8% of the newborns were classified as low birth weight (LBW), 6.0% with macrosomia, 10.2% small for gestational age (SGA), and 11.2% large for gestational age (LGA). The mean (SD) IQDAG score was 70.1 (11.8). Adjusted logistic regression models showed that women in the third tertile of the IQDAG score presented a lower risk of having LGA babies [OR 0.44 (95% CI 0.22, 0.90), p-trend = 0.02] compared to the first tertile. Women in the third tertile of omega-3 intake presented a lower risk of giving birth to LGA infants [OR 0.33 (95% CI 0.15, 0.69), p-trend = 0.00] and LBW infants [OR 0.18 (95% CI 0.04, 0.83), p-trend = 0.02] when compared to the first tertile. There was also a lower SGA trend among the children of women in the third tertile of omega-3 intake [OR 0.43 (95% CI 0.17, 1.07), p-trend = 0.03] compared to the first tertile. CONCLUSION: A better diet quality and higher omega-3 intake are protective factors for LGA babies, and increased maternal omega-3 intake reduce the risk of LBW and LGA, and may be a protective factor against the birth of SGA infants.

The role of food processing in the inflammatory potential of diet during pregnancy.

The aim was to investigate the relationship between the energy contribution (E%) of foods according to the degree of industrial processing and the energy-adjusted dietary inflammatory index (E-DII) in pregnancy. Two 24-hour dietary recalls were obtained from each of the 784 pregnant women. Adjusted linear regression models allowed observing an inverse association between E-DII scores and E% from minimally processed foods ß = -0.049 (95%CI -0.055- -0.042) and a direct association with the E% of ultra-processed foods ß = 0.052 (95%CI 0.045-0.058), indicating a relationship between the dietary inflammatory potential and the degree of industrial processing of foods.