RESUMEN

OBJECTIVE: This study explored the association between common mental disorders (CMD) and chronic low back pain (CLBP) in women, while considering poor sleep quality as a potential effect modifier of this relationship. METHODS: A cross-sectional population-based study was conducted with a representative sample of 1068 women (age 20-69 years) living in the urban area of São Leopoldo, RS, Brazil. CLBP was defined as pain lasting for ≥3 months; CMD was assessed using the Self-Reporting Questionnaire (SRQ-20; score ≥8); poor sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI; score ≥5). Poisson regression with robust variance was used to estimate the prevalence ratios (PR) with 95% confidence intervals (CI). RESULTS: The prevalence of CLBP, CMD, and poor sleep quality was 46.8% (95% CI: 43.8-49.8), 33.5% (95% CI: 30.3-36.3), and 42.3% (95% CI: 39.3-45.2), respectively. Poor sleep quality was a significant modifier of the association between CMD and CLBP. Among women with poor sleep quality, women with CMD had a 48% higher probability of having CLBP compared to women without CMD and after adjustment for confounders (PR = 1.48; 95% CI: 1.23-1.77; p < 0.001). The relationship between CMD and CLBP was not statistically significant in women with good sleep quality. CONCLUSIONS: This study revealed a significant relationship between CMD and CLBP, wherein poor sleep quality acted as an effect modifier. Women with CMD and poor sleep quality were more vulnerable to CLBP.

Asunto(s)

RESUMEN

OBJECTIVE: This study investigated the association between minor psychiatric disorders and menopause symptoms and their associated factors. METHODS: A cross-sectional study was conducted with 615 women aged 40 to 65 years treated in a public menopause and gynecological outpatient clinic in the South Region of Brazil. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20) and menopause symptoms using the Menopause Rating Scale. Score for menopause symptoms was categorized into three levels of symptoms: mild, moderate, and severe. Multivariate analyses used ordinal logistic regression. RESULTS: The prevalence of mild, moderate, and severe menopause symptoms was 34.1% (95% CI 30.3-37.9), 29.6% (95% CI 25.8-33.1), and 36.3% (95% CI 32.4-40.0), respectively. The overall prevalence of minor psychiatric disorders was 66.6% (95% CI 62.8-70.3). After adjustment, the odds ratio (OR) of the occurrence of menopause symptoms were approximately eight times higher in women relating minor psychiatric disorders compared with those without such disorders (OR = 7.76; 95% CI 5.27-11.44). The following factors were also associated with the menopause symptoms: women older than 50 years, living with a partner, lower educational level, smokers, larger number of pregnancies, obese, and those using psychotropic and/or postmenopause medication. CONCLUSIONS: The minor psychiatric disorders exhibited strong association with the presence of menopause symptoms independently of sociodemographic, behavioral, and reproductive factors, and of use of psychotropic medication.

Asunto(s)

RESUMEN

Determinar a proporção de crianças com cadernetas de saúde com preenchimento adequado e analisar associações com características geográficas, socioeconômicas e biológicas maternas e da criança e com o percentual de utilização de serviços de saúde em dois municípios do semi-árido brasileiro. Métodos: estudo transversal de base populacional com crianças até cinco anos de idade. A coleta de dados foi realizada mediante aplicação de questionários domiciliar entre julho e setembro de 2008. A presença de todos os registros na caderneta, relativos à identificação, crescimento, desenvolvimento e status vacinal da criança foi definida como preenchimento adequado. Calcularam-se as razões de prevalência brutas e ajustadas pela Regressão de Poisson, seguindo modelo hierarquizado. Resultados: entre as 342 crianças estudadas, 22,2 por cento (IC95 por cento 17,5 a 26,2) apresentavam cadernetas de saúde preenchidas de forma adequada. A alta escolaridade materna esteve associada a este evento, após ajuste do efeito das variáveis no modelo hierarquizado. Conclusões: os resultados demonstraram baixo percentual de cadernetas de saúde adequadamente preenchidas. A maior prevalência de cadernetas com preenchimento inadequado nas mães de baixa escolaridade pode denotar iniquidade no sistema de saúde local. O preenchimento adequado da caderneta um direito da criança, a sua inadequação indicou despreparo dos profissionais de saúde e dos pais às necessidades da atenção básica...

To determine the proportion of children with adequately completed health records and to investigate associations with geographical, socioeconomic and the mother and child's biological characteristics, and with the percentage use of health services in two municipalities in the semi-arid region of Brazil. Methods: a population-based cross-sectional study was carried with children aged up to five years. Data were collected by way of a household questionnaire between July and September 2008. The presence of all records relating to identification, growth, development and vaccine status of the child was deemed to be adequate completion. The raw and adjusted prevalence ratios were calculated using the Poisson Regression, following a hierarchized model. Results: of the 342 children studied, 22.2 percent (CI95 percent 17.5 - 26.2) had adequately completed health records. A high level of education of the mother was associated with this, after adjusting for the effect of variables in the hierarchized model. Conclusions: the results show a low level of adequate completion of health records. The high prevalence of inadequately completed records in mothers with low levels of education may reflect inequalities in the local health system. Children have a right to adequate completion of health records and failure to do so suggests lack of training of health workers and parents in basic health care needs...

Asunto(s)