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OBJETIVO: A relação entre exposição ambiental e risco à saúde é amplamente reconhecida e a avaliamos em cinco países da América Latina com condições culturais distintas, mas com Índices de Desenvolvimento Humano semelhantes. MÉTODOS: Estudo transversal envolvendo 3.016 indivíduos (18 a 75 anos) oriundos de: Argentina (n = 878), Brasil (n = 1.030), México (n = 272), Paraguai (n = 508) e Peru (n = 328). A seleção foi aleatória e todos responderam questionário padronizado (fatores sociodemográficos, fatores ambientais e hábitos de vida) derivado do Clinical Screening Tool for Air Pollution Risk. Segundo o estado atual de saúde, foram categorizados em: saúde regular/má/péssima ou excelente/boa. Tendo-a como desfecho, realizou-se análise multivariada.Os dados foram apresentados como razão de verossimilhança (RV) e intervalos de confiança de 95% (IC 95%), tendo-se 5% o nível de significância. RESULTADOS: Foram significantemente associados a pior percepção de situação de saúde: morar em qualquer um dos países, ter umidade na residência (OR = 1,68; IC 95%: 1,33-2,12), dirigir automóvel com janelas abertas (OR = 1,31; IC 95%: 1,03-1,65), ter baixa renda familiar (OR = 1,59; IC 95%: 1,26-2,01), nível educacional incompleto (OR = 1,54; IC 95%: 1,22-1,94), histórico pessoal/familiar de hipertensão arterial (OR = 2,25; IC 95%: 01,64-3,09), doença pulmonar obstrutiva crônica/asma (OR = 1,74; IC 95%: 1,28-2,36), diabete melito (OR = 3,74; IC 95%: 2,23-6,29), obesidade (OR = 1,84; IC 95%: 1,84-3,19) ou comorbidades oftalmológicas (OR = 1,89; IC 95%: 1,55-2,30); realizar exercícios ao ar livre (OR = 1,60; IC 95%: 1,31-1,96). CONCLUSÕES: Apesar das diferentes exposições a que foram submetidos, alguns fatores permanecem muito significativos, e ter baixa renda familiar, expor-se à poluição e ter antecedentes de doenças crônicas foram associados à percepção de condição ruim de saúde.
OBJECTIVE: The relationship between environmental exposure and health outcomes is well known.We investigated this relationship in five Latin American countries with different cultural backgrounds but similar Human Development Indexes. METHODS: This was a cross-sectional study involving 3,016 individuals (18 to 75 years old) from Argentina (n=878), Brazil (n=1030), Mexico (n=272), Paraguay (n=508), and Peru (n=328). Participants were randomly selected and responded to a standardized questionnaire (including sociodemographic and environmental factors and lifestyle habits) derived from a clinical screening tool for air pollution risk. Based on their current health status, participants were categorized as having regular/bad/very bad or excellent/good health. Multivariate analysis was conducted, and data were presented as likelihood ratios and 95% confidence intervals (95%CI).The significance level was set at 5%. RESULTS: Living in any of the study countries; indoor humidity (OR=1.68; 95%CI: 1.33-2.12); driving with the windows open (OR=1.31; 95%CI: 1.03-1.65); low family income (OR=1.59; 95%CI: 1.26-2.01); incomplete education (OR=1.54; 95%CI: 1.22-1.94); personal/family history of hypertension (OR=2.25; 95%CI: 01.643.09), chronic obstructive pulmonary disease/asthma (OR=1.74; 95%:CI: 1.28-2.36), diabetes (OR=3.74; 95%CI:2.23-6.29), obesity (OR=1.84; 95%CI: 1.84-3.19), or ocular comorbidities (OR=1.89; 95%CI: 1.55-2.30); and exercising outdoors (OR=1.60; 95%CI: 1.31-1.96) were significantly associated with a worse perceived health status. CONCLUSIONS: Despite the different exposures to which participants were subjected, some factors remain very significant. Low family income, exposure to pollution, and a history of chronic diseases were associated with the perception of a poor health condition.
Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , América LatinaRESUMO
As doenças crônicas não transmissíveis (DCNT) são um conjunto de doenças permanentes que geralmente são consequências de diversos fatores externos. Objetivo: O objetivo deste estudo foi verificar e apresentar as dificuldades enfrentadas pela enfermagem da atenção básica no contexto da assistência ao paciente portador de DCNT. Métodos: Trata-se de um estudo exploratório baseado na revisão integrativa de literatura onde foram selecionados artigos que estivessem no período de 2012 a 2022. Resultados: Constatou-se que quanto ao delineamento dos trabalhos selecionados, o maior enfoque das produções é abordagem da dimensão desse problema, aonde elencam os fatores de riscos, a importância de adesão aos tratamentos, a deficiência de investimentos por parte do governo para a ampliação das ações de promoção de saúde e assistência dos profissionais, principalmente da enfermagem. Conclusão: Conclui-se a atuação da enfermagem, especialmente no desenvolvimento da promoção e prevenção em saúde no contexto das DCNT, é de grande importância, entretanto, devido às dificuldades que influenciam no processo assistencial, a sua prática tem sido superficial.
Chronic non-communicable diseases (NCDs) are a set of permanent diseases that are usually the result of various external factors. Objective: The objective of this study was to verify and present the difficulties faced by primary care nursing in the context of care for patients with CNCDs. Methods: This is an exploratory study based on an integrative literature review where articles from 2012 to 2022 were selected. Results: It was found that regarding the design of the selected works, the main focus of the productions is the approach to the dimension of this problem, where they list the risk factors, the importance of adherence to treatments, the lack of investment by the government for the expansion of health promotion actions and professional assistance, especially nursing. Conclusion: It is concluded that the performance of nursing, especially in the development of health promotion and prevention in the context of CNCD, is of great importance, however, due to the difficulties that influence the care process, its practice has been superficial.
Las enfermedades crónicas no transmisibles (ECNT) son un conjunto de enfermedades permanentes que suelen ser el resultado de diversos factores externos. Objetivo: El objetivo de este estudio fue verificar y presentar las dificultades a las que se enfrenta la enfermería de atención primaria en el contexto de la atención a pacientes con ECNT. Métodos: Se trata de un estudio exploratorio basado en una revisión bibliográfica integradora donde se seleccionaron artículos desde 2012 hasta 2022. Resultados: Se encontró que en cuanto al diseño de los trabajos seleccionados, el foco principal de las producciones es el abordaje de la dimensión de este problema, donde enumeran los factores de riesgo, la importancia de la adherencia a los tratamientos, la falta de inversión por parte del gobierno para la ampliación de las acciones de promoción de la salud y la asistencia profesional, especialmente de enfermería. Conclusiones: Se concluye que la actuación de la enfermería, especialmente en el desarrollo de la promoción y prevención de la salud en el contexto de la ENTNC, es de gran importancia, sin embargo, debido a las dificultades que influyen en el proceso de atención, su práctica ha sido superficial.
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Resumo Introdução As doenças crônicas não transmissíveis (DCNT) são um importante problema de saúde pública e necessitam de olhar ampliado para elaboração de políticas públicas. Objetivo Identificar os principais desafios das políticas públicas de saúde para o enfrentamento das DCNT em municípios do Nordeste brasileiro. Método Revisão integrativa da literatura a partir de artigos publicados nos últimos dez anos. Os artigos considerados elegíveis foram agrupados em tabelas e discutidos frente aos subtemas: "Políticas Públicas de Saúde" e "Principais Desafios para o Enfrentamento das DCNT". Resultados Os estudos apontaram a frágil oferta de programas e serviços no âmbito municipal da região Nordeste do país. Observou-se a predominância de estudos que visam reconhecer o perfil do usuário portador de hipertensão e diabetes, que pouco contribui para o cuidado integral e de educação em saúde. Também foi possível identificar que mesmo o âmbito municipal estando mais próximo desse público, muitos são os desafios e impasses para uma eficaz promoção da saúde. Conclusão Diante dos diversos desafios identificados em todos os níveis de produção e conhecimento, sugere-se que mais estudos sejam realizados considerando o contexto das condições crônicas e que pesquisas posteriores transcrevam as demandas a partir dos gestores e usuários.
Abstract Background Chronic Noncommunicable Diseases (NCDs) are an important Public Health problem and shoud be paid more attention to the elaboration of public policies. Objective To identify the main challenges of public health policies for addressing NCDs in municipalities of northeastern Brazil. Method An integrative literature review was conducted from articles published in the last ten years. The articles considered eligible were grouped in tables and discussed on two sub-themes: "Public Health Policies" and "The main Challenges to face NCDs". Results This study pointed out to the fragile programs and services offered in the municipal level of the northeast region of the country. It was observed the predominance of publications aimed at recognizing the profile of users with Hypertension and Diabetes, which unfeasibly contributes to integral care and health education. It was also possible to identify that even though the municipal level is closest to people's daily lives, there are many challenges and impasses for an effective promotion of health and quality of life of these people. Conclusion Given the various challenges identified at all levels of production and knowledge, it is suggested that further studies may be conducted, thus considering the context of chronic conditions, and also further research can be developed to meet the demands of managers and users.
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O objetivo foi avaliar a influência do sono e da crononutrição na hipertensão e diabetes na população adulta (18 anos ou mais) em um município do Sul do Brasil. Trata-se de um estudo transversal de base populacional, desenvolvido em Criciúma, Santa Catarina, em 2019. As variáveis de exposição foram duração e qualidade do sono, e dois dos principais aspectos da crononutrição, o número de refeições diárias e a realização do café da manhã. Os desfechos estudados foram diabetes mellitus e hipertensão arterial sistêmica. Regressão de Poisson bruta e ajustada com variância robusta foi utilizada para avaliar as associações entre as exposições e os desfechos. Para todas as análises, considerou-se o efeito do desenho amostral, e o nível de significância utilizado foi de 5%. Foram estudados 820 indivíduos. As prevalências de diabetes e hipertensão foram 19,9% e 44,1%, respectivamente. Indivíduos com pior qualidade do sono tiveram prevalência 33% maior de diabetes e 17% maior de hipertensão, comparados àqueles com boa qualidade do sono. Os que realizaram quatro ou mais refeições ao dia apresentaram prevalência 16% menor de hipertensão quando comparados aos que fizeram menos de quatro refeições. Conclui-se que a qualidade do sono e o número de refeições diárias, um comportamento alimentar relacionado à crononutrição, estiveram relacionados à hipertensão e ao diabetes. Tais resultados destacam a importância de ações de saúde pública que abordem novas estratégias para o enfrentamento dessas doenças, voltadas à qualidade do sono e à crononutrição.
The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.
El objetivo fue evaluar la influencia del sueño y la crononutrición sobre la hipertensión arterial y la diabetes en la población adulta (18 años o más) en un municipio del Sur de Brasil. Se trata de un estudio transversal de base poblacional, desarrollado en Criciúma, Santa Catarina, en el 2019. Las variables de exposición fueron la duración y la calidad del sueño, y dos de los principales aspectos de la crononutrición, el número de comidas diarias y el consumo de desayuno. Los desenlaces estudiados fueron la diabetes mellitus e la hipertensión arterial sistémica. Se utilizó la regresión de Poisson cruda y ajustada con varianza robusta para evaluar las asociaciones entre las exposiciones y los desenlaces. Para todos los análisis, se consideró el efecto del diseño de la muestra y el nivel de significación utilizado fue del 5%. Se estudiaron 820 individuos. Las prevalencias de diabetes e hipertensión fueron de 19,9% y del 44,1%, respectivamente. Las personas con peor calidad del sueño tuvieron una prevalencia de diabetes un 33% mayor y una prevalencia de hipertensión un 17% mayor, en comparación con las personas con una buena calidad del sueño. Los que efectuaron cuatro o más comidas al día presentaron una prevalencia de hipertensión un 16% menor en comparación con los que efectuaron menos de cuatro comidas. Se concluye que la calidad del sueño y el número de comidas diarias, una conducta alimentaria relacionada con la crononutrición, están relacionados con la hipertensión arterial y la diabetes. Estos resultados destacan la importancia de acciones de salud pública que aborden nuevas estrategias de enfrentamiento a estas enfermedades, centradas en la calidad del sueño y en la crononutrición.
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Humanos , Adulto , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Sono , Brasil/epidemiologia , Estudos TransversaisRESUMO
Introducción: La calidad de vida relacionada con la salud, como indicador positivo que evalúa el proceso salud-enfermedad, ha ido ganando en uso, a partir del cambio en los patrones de morbilidad, generado por el envejecimiento demográfico. Objetivo: Caracterizar la calidad de vida relacionada con la salud desde la perspectiva nomotética y su relación con variables de personas y tiempo. Métodos: Se realizó un estudio descriptivo-transversal en 200 adultos con diagnóstico de diabetes mellitus, hipertensión arterial o ambas, atendidos en el centro Daniel Álvarez, de Loja quienes cumplían varios criterios. Se calcularon medias y desviaciones típicas, porcentajes, y pruebas de significación como ANOVA, comparación de medias en muestras independientes y Análisis de Tablas de Contingencia, a través de la Razón de Verosimilitud, con un nivel de significación del 5 por ciento. Resultados: El puntaje promedio de la calidad de vida fue de 2,90, sin asociaciones significativas con las variables investigadas (p > 0,05). Las dimensiones física (3,30) y relaciones sociales (3,09) puntuaron por encima, mientras la psicológica (2,71) y el ambiente (2,70) lo hicieron por debajo. Solo la escolaridad, para la dimensión psicológica (p = 0,03) se asoció de manera significativa al puntaje alcanzado por esta. Conclusiones: La calidad de vida relacionada con la salud global, desde una perspectiva nomotética, en los adultos objeto de estudio, mostró un nivel aceptable, no asociada a ninguna de las variables en estudio. Los dominios psicológico y ambiente obtuvieron el peor puntaje; en tanto el físico y las relaciones sociales exhibieron niveles superiores al global(AU)
Introduction: Health-related quality of life, as a positive indicator that evaluates the health-disease process, has been gaining more use, due to the change in morbidity patterns, generated by demographic aging. Objective: To characterize health-related quality of life from the nomothetic perspective and its relationship with variables of people and time. Methods: A descriptive and cross-sectional study was carried out with 200 adults with a diagnosis of diabetes mellitus, hypertension, or both, cared for at Daniel Álvarez center, in Loja, who met several criteria. Means and standard deviations were calculated, together with percentages. Significance tests such as ANOVA, comparison of means in independent samples, and analysis of contingency tables were carried out, using likelihood ratio, with a significance level of 5 percent. Results: The average score for quality of life was 2.90, without significant associations with the variables investigated (0.05). The physical (3.30) and social relations (3.09) dimensions scored higher, while the psychological (2.71) and the environmental (2.70) scored lower. Only schooling, for the psychological dimension (P=0.03), was significantly associated with its achieved score. Conclusions: The global health-related quality of life in the adults under study, from a nomothetic perspective, showed an acceptable level, not associated with any of the variables analyzed. The psychological and environmental domains obtained the worst scores, while the physical and social relations dimensions exhibited levels higher than the global one(AU)
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Humanos , Masculino , Feminino , Qualidade de Vida , Diabetes Mellitus/diagnóstico , Doenças não Transmissíveis/epidemiologia , Hipertensão/diagnóstico , Epidemiologia Descritiva , Estudos TransversaisRESUMO
ABSTRACT: Objective: The objective of this study was to investigate the use of health services and limitations in performing usual activities by adults and elderly people with and without noncommunicable chronic diseases (NCDs), according to sociodemographic strata. Methods: This is a cross-sectional study in which data from the 2019 National Health Survey were analyzed. The final sample corresponded to 88,531 households with interviews carried out, referring to individuals aged 18 years and above. The prevalence of use of services by the population with NCDs was compared with that of the population without NCDs and stratified by socioeconomic and demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were calculated. Results: In 2019, 47.6% (95%CI 47.0-48.3) of the population reported having one or more NCDs. Population with NCDs had more medical consultations in the last 12 months (adjusted PR [APR]=1.21; 95%CI 1.20-1.23), used more health services in the last 2 weeks (APR=2.01; 95%CI 1.91-2.11), were referred to more hospitalization (APR=2.11; 95%CI 1.89-2.36), and had more limitations in performing usual activities (APR=2.52; 95%CI 2.30-2.76), compared with the population without NCDs. A positive dose-response gradient was observed between the number of comorbidities and the use of services. In all socioeconomic and demographic strata, the prevalence of indicators was higher in people with NCDs. Conclusion: The presence of NCDs was associated with a higher frequency of use of health services (i.e., consultation, use of services, and hospitalization) and the restriction of usual activities in all socioeconomic and demographic strata.
RESUMO: Objetivo: Investigar a utilização de serviços de saúde e a limitação das atividades habituais entre adultos e idosos com e sem doenças crônicas não transmissíveis, segundo estratos sociodemográficos. Métodos: Estudo transversal, no qual foram analisados dados da Pesquisa Nacional de Saúde de 2019. A amostra final correspondeu a 88.531 domicílios, com entrevistas referentes a indivíduos maiores de 18 anos. As prevalências de uso de serviços pela população com doenças crônicas não transmissíveis foram comparadas às da população sem essas patologias e estratificadas por variáveis socioeconômicas e demográficas. Razões de prevalência (RP) e intervalos de confiança de 95% foram calculados. Resultados: Em 2019, 47,6% (IC95% 47,0-48,3) da população referiu ter uma ou mais doenças crônicas não transmissíveis. A população com registro dessas patologias realizou mais consulta médica nos últimos 12 meses (RPaj=1,21; IC95% 1,20-1,23), utilizou mais o serviço de saúde nas duas últimas semanas (RPaj=2,01; IC95% 1,91-2,11), referiu mais internações (RPaj=2,11; IC95% 1,89-2,36) e mais limitação da realização de atividades (RPaj=2,52 vezes; IC95% 2,30-2,76) em comparação com a população isenta desse tipo de registro. Observou-se gradiente dose-resposta positivo entre número de comorbidades e uso de serviços. Em todos os estratos socioeconômicos e demográficos, a prevalência dos indicadores foi mais elevada em pessoas com doenças crônicas não transmissíveis. Conclusão: A presença dessas doenças associou-se à maior frequência de uso de serviços de saúde (consulta médica, uso de serviços de saúde e internação) e da restrição das atividades habituais em todos os estratos socioeconômicos e demográficos.
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Humanos , Adulto , Idoso , Doenças não Transmissíveis/terapia , Doenças não Transmissíveis/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Inquéritos Epidemiológicos , Serviços de SaúdeRESUMO
Diabetes is the second most prevalent non-communicable chronic diseases (NCDs) in patients with coronavirus disease 2019 (COVID-19) and is highly associated with increased incidence of disease severity and mortality. Individuals with diabetes and poor glycemic control have an even worse prognosis. Despite of the need/effectiveness of social distancing measures (i.e.: home confinement, quarantine and/or lockdown) during COVID-19 outbreak, preliminary findings showed an increase in negative behaviors during COVID-19 home confinement (i.e.: ~33.5% reduction in physical activity, ~28.6% (~3.10h) increase in sedentary behavior (i.e.: daily sitting, reclining and lying down time), and more unhealthy food consumption and meal pattern), which may have important clinical implications. For example, we estimated that this reduction in physical activity can increase the cases of type 2 diabetes (from ~7.2% to ~9.6%; ~11.1 million cases per year) and all-cause mortality (from ~9.4% to ~12.5%; ~1.7 million deaths per year) worldwide. Few weeks of reduction in physical activity levels result in deleterious effects on several cardiometabolic (i.e.: glycemic control, body composition, inflammatory cytokines, blood pressure, vascular function ) and functional parameters (i.e.: cardiorespiratory/muscle fitness, balance, agility ). In contrast, physical activity and exercise are important tools for preventing and treating diabetes and others NCDs. Home-based exercise programs are useful, safe and effective for the management of diabetes, and could be widely used during COVID-19 outbreak. In this context, there is an urgent need for recommending physical activity/exercise, during and beyond COVID-19 outbreak, for improving the management of diabetes, as well as to prevent the increase in global burden of COVID-19, diabetes and others NCDs.
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COVID-19/epidemiologia , Diabetes Mellitus/prevenção & controle , Exercício Físico , Promoção da Saúde/métodos , Avaliação das Necessidades/normas , Guias de Prática Clínica como Assunto/normas , SARS-CoV-2/isolamento & purificação , COVID-19/transmissão , COVID-19/virologia , Diabetes Mellitus/virologia , Surtos de Doenças , HumanosRESUMO
Background: The number of deaths from noncommunicable chronic diseases (NCDs) has increased worldwide. These deaths would be partly avoidable if prevention and follow-up measures were applied to reduce risk factors. Computing can help educate individuals, improving their knowledge about NCDs. This article presents a systematic mapping of studies that apply computing to education on NCDs. The results allow a general view of the literature and the identification of research opportunities. Materials and Methods: The methodology followed three steps: (1) definition of search databases from computer science and health sciences, (2) selection of keywords for search string composition, and (3) application of inclusion and exclusion criteria to filter the results. The survey occurred from January 2008 to April 2018. Results: The initial search resulted in 19,675 papers, of which 38 were selected after applying the filter criteria. The use of mobile computing stood out in 25 papers. The education modalities were self-management and educational content for diabetes (10 papers), asthma (1), cardiovascular disease (1) and chronic diseases (1), self-management of diabetes and games (1), educational content (15), games (6), personalized content (2), and virtual community (1). The percentage of papers on diabetes was 65%. Most solutions (55%) do not use data from individuals to provide information considering their health condition. In addition, 19 papers produced outcome measures by means of experiments. Conclusions: Mobile computing was the most used technology in the papers. In addition, self-management, educational content, and games were the most used mechanisms. A research opportunity consists of personalized assistance. In this sense, ubiquitous learning can provide a continuous and contextualized education.
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Doenças não Transmissíveis , Educação de Pacientes como Assunto , Asma/terapia , Doenças Cardiovasculares/terapia , Doença Crônica , Diabetes Mellitus/terapia , Gerenciamento Clínico , Humanos , Aplicativos Móveis , AutocuidadoRESUMO
Chile has experienced rapid epidemiological transitions characterized by decreasing infant mortality, population aging, and a shift towards obesity with an increase in noncommunicable diseases (NCDs). Today, tobacco, alcohol, and ultraprocessed foods are the main risk factors for these diseases. Based on Chile's experience in tobacco control, we discuss paths to make progress in population evidence-based strategies to improve overall community health.
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Bebidas Alcoólicas , Doença Crônica , Alimentos , Política de Saúde , Legislação como Assunto , Doenças não Transmissíveis , Saúde Pública , Produtos do Tabaco , Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/normas , Chile , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Alimentos/normas , Política de Saúde/legislação & jurisprudência , Humanos , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/prevenção & controle , Saúde Pública/legislação & jurisprudência , Saúde Pública/normas , Ciência , Produtos do Tabaco/legislação & jurisprudência , Produtos do Tabaco/normasRESUMO
Introducción: Las enfermedades crónicas no transmisibles (ECNT) son las principales causas de muerte en el mundo, que corresponde al 26% de las muertes en nuestro país y su prevalencia se ha incrementado en un 10 % en los últimos 15 años. La forma de prevenir y controlar las ECNT es a través de una acción global e integrada. La extensión universitaria es un proceso pedagógico transformador en el que alumnos y docentes pueden influir en los estilos de vida de la población, mediante proyectos de intervención comunitaria. Metodología: El proyecto se desarrollo en 3 fases; la primera fase de diagnostico y primera encuesta sobre conocimiento de ECNT, la segunda de intervención y una tercera donde se aplico una segunda encuesta. Resultados: El proyecto se extendió en el año 2017 con 4 visitas. Dando como resultados los siguientes datos socios demográficos: 36 familias estables, 59 habitantes corresponden al género femenino y 54 al masculino. El 97% son paraguayos. 38,5% finalizo la primaria. En el sexo masculino la profesión fue de empleados 34,6%, de comerciante 18,6%; en el sexo femenino fue de quehaceres domésticos 63,4%. La jefatura de hogar masculina predomina en un 75% el sexo masculino. La patología predominante en adultos es la de HTA. Luego de aplicadas las intervenciones educativas se logró mejorar el conocimiento sobre la diabetes de nivel de conocimiento malo a regular y respecto a la hipertensión el nivel de conocimiento aumento de regular a buena. Conclusión: Los pacientes mejoraron el conocimiento sobre las ECNT, por lo cual se demostró el beneficio de la intervención mediante este proyecto de extensión universitaria.
Introduction: Chronic noncommunicable diseases (NCDs) are the main causes of death in the world, which corresponds to 26% of deaths in our country and its prevalence has increased by 10% in the last 15 years. The way to prevent and control CNCDs is through a global and integrated action. The university extension is a transformative pedagogical process in which students and teachers can influence the lifestyles of the population through community intervention projects. Methodology: The project was developed in 3 phases; the first phase of diagnosis and first survey on knowledge of NCDs, the second of intervention and a third where a second survey was applied. Results: The project was extended in 2017 with 4 visits. Giving as results the following data demographic partners: 36 stable families, 59 inhabitants correspond to the feminine gender and 54 to the masculine. 97% are Paraguayan. 38.5% finished primary school. In the male sex, the profession was 34.6% employees, 18.6% merchant; in the female sex, it was household chores 63.4%. The male head of household dominates the male sex by 75%. The predominant pathology in adults is that of HTN. After applying the educational interventions, it was possible to improve the knowledge about diabetes from the level of bad knowledge to regular and regarding hypertension, the level of knowledge increased from regular to good. Conclusion: Patients improved their knowledge about CNCDs, which is why the benefit of the intervention was demonstrated through this university extension project.
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Introducción: las enfermedades crónicas no transmisibles representan una carga de morbilidad importante mundialmente, la falta de adherencia a los tratamientos tiene repercusiones médicos, económicas y psicosocial. Objetivo: caracterizar la adherencia terapéutica en pacientes con algunas enfermedades crónicas no transmisibles. Métodos: estudio descriptivo longitudinal retrospectivo en el consultorio médico 13 perteneciente al policlínico "Octavio de la Concepción y la Pedraja" del municipio Camajuaní. Población conformada por todos los pacientes con diagnóstico de Enfermedades Crónicas no Transmisibles (182). La muestra fue seleccionada por muestreo no probabilístico por criterios (68). Se aplicó un cuestionario para contrastar la información recogida en la historia de salud familiar e historias clínicas. El nivel de conocimientos se evaluó por medio de un cuestionario diagnóstico. Resultados: predominó el grupo de edad de 80 y más años (20,5 por ciento) y el sexo femenino; según control de la afección, se constató que del total, 55,8 por ciento no cumplía los criterios de adherencia terapéutica, de ellos, el 47,0 por ciento y 35,2 por ciento se encontraban parcialmente controlado y no controlado respectivamente. Dentro de las causas de mal control de enfermedades crónicas predominó la inadecuada adherencia al tratamiento médico (90,5 por ciento), resultó significativo para las distintas enfermedades crónicas la inadecuada adherencia terapéutica, existiendo relación entre el nivel de conocimientos y la adherencia terapéutica, predominando el bajo nivel de conocimientos con no adherencia terapéutica. Conclusiones: la falta de adherencia terapéutica se asoció al bajo nivel de conocimientos y al mal control de enfermedades crónicas(AU)
Introduction: Chronic noncommunicable diseases represent a major burden for morbidity worldwide. Lack of adherence to treatments has medical, economic and psychosocial repercussions. Objective: To characterize therapeutic adherence in patients with some chronic noncommunicable diseases. Methods: Retrospective, longitudinal, descriptive study performed in the family physician's office # 13 belonging to Octavio de la Concepción y Pedraja Polyclinic in Camajuaní Municipality. The population was made up of all patients diagnosed with chronic noncommunicable diseases (182). The sample was chosen using nonprobabilistic sampling by criteria (68). A questionnaire was applied to compare information collected in the history of family health and medical records. The level of knowledge was assessed by means of a diagnostic questionnaire. Results: The age group 80 and over (20.5 percent) and the female sex were predominant. According to the affection's control, 55.8 percent did not meet the adherence criteria, a figure of which 47.0 percent and 35.2 percent were partially controlled and not controlled, respectively. Among the causes of poor control of chronic diseases, inadequate adherence to medical treatment (90.5 percent) predominated, inadequate therapeutic adherence was significant for the different chronic diseases, and there was a relationship between the level of knowledge and therapeutic adherence, with a predominant low level of knowledge with lack of therapeutic adherence. Conclusions: Lack of therapeutic adherence was associated with low level of knowledge and poor control of chronic diseases(AU)
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Doenças não Transmissíveis , Cooperação e Adesão ao Tratamento , Epidemiologia Descritiva , Estudos Longitudinais , Estudos RetrospectivosRESUMO
Introducción: las enfermedades crónicas no transmisibles representan una carga de morbilidad importante mundialmente, la falta de adherencia a los tratamientos tiene repercusiones médicos, económicas y psicosocial. Objetivo: caracterizar la adherencia terapéutica en pacientes con algunas enfermedades crónicas no transmisibles. Métodos: estudio descriptivo longitudinal retrospectivo en el consultorio médico 13 perteneciente al policlínico Octavio de la Concepción y la Pedraja del municipio Camajuaní. Población conformada por todos los pacientes con diagnóstico de Enfermedades Crónicas no Transmisibles (182). La muestra fue seleccionada por muestreo no probabilístico por criterios (68). Se aplicó un cuestionario para contrastar la información recogida en la historia de salud familiar e historias clínicas. El nivel de conocimientos se evaluó por medio de un cuestionario diagnóstico. Resultados: predominó el grupo de edad de 80 y más años (20,5 por ciento) y el sexo femenino; según control de la afección, se constató que del total, 55,8 por ciento no cumplía los criterios de adherencia terapéutica, de ellos, el 47,0 por ciento y 35,2 por ciento se encontraban parcialmente controlado y no controlado respectivamente. Dentro de las causas de mal control de enfermedades crónicas predominó la inadecuada adherencia al tratamiento médico (90,5 por ciento), resultó significativo para las distintas enfermedades crónicas la inadecuada adherencia terapéutica, existiendo relación entre el nivel de conocimientos y la adherencia terapéutica, predominando el bajo nivel de conocimientos con no adherencia terapéutica. Conclusiones: la falta de adherencia terapéutica se asoció al bajo nivel de conocimientos y al mal control de enfermedades crónicas(AU)
Introduction: Chronic noncommunicable diseases represent a major burden for morbidity worldwide. Lack of adherence to treatments has medical, economic and psychosocial repercussions. Objective: To characterize therapeutic adherence in patients with some chronic noncommunicable diseases. Methods: Retrospective, longitudinal, descriptive study performed in the family physician's office # 13 belonging to Octavio de la Concepción y Pedraja Polyclinic in Camajuaní Municipality. The population was made up of all patients diagnosed with chronic noncommunicable diseases (182). The sample was chosen using nonprobabilistic sampling by criteria (68). A questionnaire was applied to compare information collected in the history of family health and medical records. The level of knowledge was assessed by means of a diagnostic questionnaire. Results: The age group 80 and over (20.5 percent) and the female sex were predominant. According to the affection's control, 55.8 percent did not meet the adherence criteria, a figure of which 47.0 percent and 35.2 percent were partially controlled and not controlled, respectively. Among the causes of poor control of chronic diseases, inadequate adherence to medical treatment (90.5 percent) predominated, inadequate therapeutic adherence was significant for the different chronic diseases, and there was a relationship between the level of knowledge and therapeutic adherence, with a predominant low level of knowledge with lack of therapeutic adherence. Conclusions: Lack of therapeutic adherence was associated with low level of knowledge and poor control of chronic diseases(AU)
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Doenças não Transmissíveis/tratamento farmacológico , Cooperação e Adesão ao Tratamento , Epidemiologia Descritiva , Estudos Longitudinais , Estudo ObservacionalRESUMO
Introducción: la falta de adherencia al tratamiento en el contexto de las enfermedades crónicas es considerada como un grave problema de salud. Objetivo: examinar los conocimientos más generales y actualizados acerca de la adherencia terapéutica en tratamientos a largo plazo. Fuente de datos: se revisaron las bases de datos bibliográficos de Medline y Google e identificaron los estudios sobre adherencia publicados entre los años 2009-2014. Se utilizaron las siguientes palabras claves: adherencia al tratamiento, adherencia terapéutica envejecimiento, enfermedades crónicas no transmisibles. Síntesis de los datos: la información recopilada se expone en cinco acápites en los que se hace un recorrido destacando primeramente los elementos que permiten diferenciar la definición de la adherencia a los tratamientos, o adherencia terapéutica, con respecto al de cumplimiento de los tratamientos; se relacionan los factores que influyen en su presentación, y se comenta sobre los métodos para su valoración, los modelos teóricos que explican la adherencia terapéutica así como sobre las cuestiones más importantes a tener en cuenta en estrategias diseñadas para su mejoramiento. La falta de adherencia constituye un problema del que es preciso conocer su prevalencia real para cada entidad o enfermedad con la finalidad, en último término, de combatirla y mejorar el nivel de salud del paciente. Conclusiones: la adherencia al tratamiento resulta un proceso muy complejo que requiere aún de educación sanitaria a la población y también a los prestadores de salud, mayor investigación y el diseño de estrategias de intervención que incluyan redes de apoyo al enfermo y su participación activa y responsable en la construcción del tratamiento(AU)
Introduction: non-adherence to treatment in chronic diseases is regarded as a serious health problem. Objective: to submit a literature review of the most general knowledge on adherence to treatment in long-term therapies. Data source: Medline and Google bibliographic databases were reviewed and identified articles disclosed between 2009-2014. The used keywords were adherence to treatment, therapeutic adherence, aging, non-communicable chronic diseases. Data synthesis: the collected information was described in five paragraphs highlighting the elements that allow us to differentiate the definition of adherence to treatment, or therapeutic adherence, with respect to compliance with treatments. The factors having an impact on the adherence were listed; the methods for assessing it, the theoretical models that explain therapeutic adherence as well as the most important questions to be taken into account in strategies aimed at improving it were all commented on. Non-adherence is a problem the real prevalence of which must be determined for each entity or disease, with the ultimate goal of eliminating it and improving the patient's health. Conclusions: adherence to treatment is a very complex process that still requires health education of the population and of the health care providers, further research and design of intervention strategies involving networks of support to the patient and their active and responsible participation in the construction of the treatment(AU)
Assuntos
Humanos , Envelhecimento , Doença Crônica/terapia , Cooperação e Adesão ao TratamentoRESUMO
Las funciones de la reproducción humana y la enfermedad propia o asociada en la gestante, se identifican e interactúan en ella con frecuencia e impacto de diversa magnitud. Los autores de este informe decidieron evaluar el curso de la gestación, el parto y el posparto en 1 093 grávidas con diagnóstico confirmado de enfermedades crónicas no transmisibles -- hemoglobinopatías de tipo S, hipertensión arterial, cardiopatías, diabetes y anemias deficitarias --, así como algunos parámetros de interés en sus hijos; ambos tratados en el Hospital Ginecoobstétrico Docente "Tamara Bunke Bider", en el Centro de Cirugía Cardiovascular y en servicios diversos del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, durante el período 1985-2009. A tal fin fueron seleccionadas las variables: prevalencia, edad, paridad, estado nutricional de la madre (índice de masa corporal), índice de cesárea primitiva, partos pretérmino y postérmino, bajo y alto peso del recién nacido y estado nutricional del recién nacido (crecimiento retardado y crecimiento acelerado), para, finalmente, analizar la morbilidad neonatal y materna y la mortalidad perinatal y materna.
The functions of human reproduction and the main or associated disease in the pregnant woman are identified and related to them with frequency and impact of different magnitude. The authors of this report decided to evaluate the course of pregnancy, childbirth and postpartum in a group of 1 093 pregnant women with a confirmed diagnosis of noncommunicable chronic diseases -- type S hemoglobinopathies, hypertension, heart disease, diabetes and deficit anemia -- as well as some parameters of interest in their children; both treated in "Tamara Bunke Bider" Obstetrics and Gynecology Teaching Hospital, in the Cardiovascular Surgery Center and different services of "Saturnino Lora Torres" Provincial Clinical Surgical Teaching Hospital from Santiago de Cuba. With this purpose variables were selected: prevalence, age, parity, and nutritional status of the mother (body mass index), index of primitive cesarean section, preterm and post-term births, low and high birth weight and nutritional status of the newborn (retarded and accelerated growth) to finally analyze the neonatal and maternal morbidity and perinatal and maternal mortality.