RESUMO
Hypertension is a major cardiovascular disease risk factor (1,2). Advice given by health professionals can result in lower sodium intake and lower blood pressure (3).The 2017 Hypertension Guideline released by the American College of Cardiology and the American Heart Association emphasizes nonpharmacologic approaches, including sodium reduction, as important components of hypertension prevention and treatment (4). Data from 50,576 participants in the sodium module of the 2015 Behavioral Risk Factor Surveillance System (BRFSS) in nine states and Puerto Rico were analyzed to determine the prevalence of reported sodium reduction advice and action among participants with and without self-reported hypertension. Among participants with self-reported hypertension, adjusted prevalence of receiving sodium reduction advice from a health professional was 41.9%, compared with 12.8% among participants without hypertension. Among those with hypertension, adjusted prevalence of reported action to reduce sodium intake was 80.9% among participants who received advice and 55.7% among those who did not receive advice. Among participants without hypertension, adjusted prevalence of taking action to reduce sodium intake was 72.7% among those who received advice and 46.9% among those who did not receive advice. The provision of advice on sodium reduction by health professionals is associated with respondent action to watch or reduce sodium intake. Fewer than half of patients with hypertension received this advice from their health professionals, a circumstance that represents a substantial missed opportunity to promote hypertension prevention and treatment.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Hipertensão/epidemiologia , Sódio na Dieta/administração & dosagem , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Estudos Transversais , Feminino , Humanos , Hipertensão/prevenção & controle , Masculino , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Autorrelato , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Excess sodium intake is a major risk factor for hypertension, and subsequently, heart disease and stroke, the first and fifth leading causes of U.S. deaths, respectively. During 2011-2012, the average daily sodium intake among U.S. adults was estimated to be 3,592 mg, above the Healthy People 2020 target of 2,300 mg. To support strategies to reduce dietary sodium intake, 2013 Behavioral Risk Factor Surveillance System (BRFSS) data from states and territories that implemented the new sodium-related behavior module were assessed. Across 26 states, the District of Columbia (DC), and Puerto Rico, 39%-73% of adults reported taking action (i.e., watching or reducing sodium intake) (median = 51%), and 14%-41% reported receiving advice from a health professional to reduce sodium intake (median = 22%). Compared with adults without hypertension, a higher percentage of adults with self-reported hypertension reported taking action and receiving advice to reduce sodium intake. For states that implemented the module, these results can serve as a baseline to monitor the effects of programs designed to reduce sodium intake.
Assuntos
Dieta/psicologia , Hipertensão/epidemiologia , Sódio na Dieta/administração & dosagem , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Aconselhamento Diretivo/estatística & dados numéricos , District of Columbia/epidemiologia , Humanos , Relações Médico-Paciente , Porto Rico/epidemiologia , Autorrelato , Sódio na Dieta/efeitos adversos , Estados Unidos/epidemiologiaRESUMO
INTRODUCTION: On the basis of results from the National Lung Screening Trial (NLST), national guidelines now recommend using low-dose computed tomography (LDCT) to screen high-risk smokers for lung cancer. Our study objective was to characterize the knowledge, attitudes, and beliefs of primary care providers about implementing LDCT screening. METHODS: We conducted semistructured interviews with primary care providers practicing in New Mexico clinics for underserved minority populations. The interviews, conducted from February through September 2014, focused on providers' tobacco cessation efforts, lung cancer screening practices, perceptions of NLST and screening guidelines, and attitudes about informed decision making for cancer screening. Investigators iteratively reviewed transcripts to create a coding structure. RESULTS: We reached thematic saturation after interviewing 10 providers practicing in 6 urban and 4 rural settings; 8 practiced at federally qualified health centers. All 10 providers promoted smoking cessation, some screened with chest x-rays, and none screened with LDCT. Not all were aware of NLST results or current guideline recommendations. Providers viewed study results skeptically, particularly the 95% false-positive rate, the need to screen 320 patients to prevent 1 lung cancer death, and the small proportion of minority participants. Providers were uncertain whether New Mexico had the necessary infrastructure to support high-quality screening, and worried about access barriers and financial burdens for rural, underinsured populations. Providers noted the complexity of discussing benefits and harms of screening and surveillance with their patient population. CONCLUSION: Providers have several concerns about the feasibility and appropriateness of implementing LDCT screening. Effective lung cancer screening programs will need to educate providers and patients to support informed decision making and to ensure that high-quality screening can be efficiently delivered in community practice.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Pulmonares/diagnóstico por imagem , Programas de Rastreamento/métodos , Médicos de Atenção Primária/psicologia , Tomografia Computadorizada por Raios X/métodos , Aconselhamento Diretivo/estatística & dados numéricos , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Feminino , Fidelidade a Diretrizes/normas , Implementação de Plano de Saúde , Humanos , Entrevistas como Assunto , Neoplasias Pulmonares/prevenção & controle , Masculino , Programas de Rastreamento/normas , Área Carente de Assistência Médica , New Mexico , Assistentes Médicos/psicologia , Serviços Preventivos de Saúde/estatística & dados numéricos , Relações Profissional-Paciente , Pesquisa Qualitativa , Doses de Radiação , Fatores de Risco , Fumar/efeitos adversos , Abandono do Hábito de Fumar/métodosRESUMO
The willingness of male-male dyads to use couples voluntary HIV counseling and testing (CVCT) has not been previously investigated globally among men who have sex with men (MSM). Using online advertisements, data were collected from 3245 MSM in seven countries who were ≥ 18 years of age and had ≥1 male sex partner in the previous 12 months. The analysis examined associations between individual characteristics and willingness to utilize CVCT. The willingness to utilize CVCT was compellingly high, ranging from 79% in Australia and UK to 90% in Brazil. Older MSM and those who reported not knowing their sero-status reported lower odds of willingness to use CVCT. The relationship between being in a relationship and willingness to use CVCT varied across countries, perhaps reflecting varied local understandings of the nature and content of CVCT. Further work is required to examine willingness to use CVCT among a more heterogeneous population of MSM, and to examine how CVCT services are locally perceived in order to provide information vital for the development of locally appropriate messages to promote CVCT for MSM.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Soropositividade para HIV/diagnóstico , Homossexualidade Masculina , Programas de Rastreamento , Comportamento Sexual , Parceiros Sexuais , Adolescente , Adulto , Austrália , Brasil , Canadá , Características da Família , Soropositividade para HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Homossexualidade Masculina/psicologia , Humanos , Internet , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/psicologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Apoio Social , África do Sul , Tailândia , Reino Unido , Estados Unidos , VoliçãoRESUMO
Tobacco use is the leading cause of preventable mortality in the world. Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) states that countries should promote cessation of tobacco use and adequate treatment for tobacco dependence. Health-care providers asking all patients about their tobacco use and advising tobacco users to quit are evidence-based strategies that increase tobacco abstinence. This report examines the proportion of tobacco smokers in 17 countries responding to the Global Adult Tobacco Survey (GATS) who saw a health-care provider in the past year and who reported that a health-care provider asked them about smoking and advised them to quit. Respondents were tobacco smokers aged ≥15 years surveyed during 2008-2011 in Bangladesh, Brazil, China, Egypt, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Romania, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam. The proportion of smokers who had visited a health-care provider during the previous 12 months ranged from 21.6% in Egypt to 62.3% in Poland. Among these, the proportion reporting that a health-care provider asked if they smoked ranged from 34.9% in Vietnam to 82.1% in Romania. Among those screened for tobacco use, those who reported their health-care providers advised them to quit ranged from 17.3% in Mexico to 67.3% in Romania. In most countries, persons aged ≥45 years were more likely to report being screened and advised to quit than were persons aged ≤24 years. Health-care providers should identify smokers and provide advice and assistance in quitting at each visit as an adjunct to effective community interventions (e.g., increased price of tobacco products; smoke-free policies, mass media campaigns, and tobacco quitlines).
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Adolescente , Adulto , Fatores Etários , Idoso , Ásia , Brasil , Egito , Europa Oriental , Feminino , Saúde Global , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Fatores Sexuais , População Urbana/estatística & dados numéricos , Uruguai , Adulto JovemRESUMO
OBJECTIVE: Couple-oriented posttest HIV counselling (COC) provides pregnant women with tools and strategies to invite her partner to HIV counselling and testing. We conducted a randomized trial of the efficacy of COC on partner HIV testing in low/medium HIV prevalence settings (Cameroon, Dominican Republic, Georgia, India). METHODS: Pregnant women were randomized to receive standard posttest HIV counselling or COC and followed until 6 months postpartum. Partner HIV testing events were notified by site laboratories, self-reported by women or both combined. Impact of COC on partner HIV testing was measured in intention-to-treat analysis. Socio-behavioural factors associated with partner HIV testing were evaluated using multivariable logistic regression. RESULTS: Among 1943 pregnant women enrolled, partner HIV testing rates (combined indicator) were 24.7% among women from COC group versus 14.3% in standard posttest HIV counselling group in Cameroon [odds ratio (OR) = 2.0 95% CI (1.2-3.1)], 23.1 versus 20.3% in Dominican Republic [OR = 1.2 (0.8-1.8)], 26.8 versus 1.2% in Georgia [OR = 29.6 (9.1-95.6)] and 35.4 versus 26.6% in India [OR = 1.5 (1.0-2.2)]. Women having received COC did not report more conjugal violence or union break-ups than in the standard posttest HIV counselling group. The main factors associated with partner HIV testing were a history of HIV testing among men in Cameroon, Dominican Republic and Georgia and the existence of couple communication around HIV testing in Georgia and India. CONCLUSION: A simple prenatal intervention taking into account the couple relationship increases the uptake of HIV testing among men in different socio-cultural settings. COC could contribute to the efforts towards eliminating mother-to-child transmission of HIV.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Soropositividade para HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Complicações Infecciosas na Gravidez/prevenção & controle , Adulto , Camarões/epidemiologia , República Dominicana/epidemiologia , Feminino , República da Geórgia/epidemiologia , Soropositividade para HIV/diagnóstico , Soropositividade para HIV/psicologia , Humanos , Índia/epidemiologia , Masculino , Programas de Rastreamento , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/psicologia , Cuidado Pré-Natal , Atenção Primária à Saúde , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologiaRESUMO
BACKGROUND: Little is known about patients' health literacy regarding antiretroviral therapy (ART) adherence and drug resistance and patient-provider communication about these topics. DESIGN AND METHODS: The AIDS Treatment for Life International Survey was a multicountry cross-sectional study (January-March 2010) including 2035 HIV-infected adults. A 40-minute interview was conducted using a standardized self-report adherence questionnaire. RESULTS: Overall, 57% of patients reported a 30-day recall of 100% adherence (Latin America: 89%; Africa: 73% vs North America: 45% and Asia Pacific: 47%; P < .01). Overall, 18% identified HIV drug resistance as a "good thing" in North America (35%) and Africa (24%). Only 71% said their health care providers had offered practical recommendations about adherence, 62% of the patients in North America and 80% in Latin America and Africa. CONCLUSIONS: Optimal ART adherence remains a challenge globally. There is a critical need to improve patient-provider communication about the importance of ART adherence and its benefits for patient's health.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Comunicação , Aconselhamento Diretivo/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Conhecimento do Paciente sobre a Medicação/estatística & dados numéricos , Adolescente , Adulto , África , Austrália , Brasil , Estudos Transversais , Coleta de Dados , Europa (Continente) , Feminino , Humanos , Masculino , Relações Médico-Paciente , República da Coreia , Estados Unidos , Adulto JovemRESUMO
Counseling for human immunodeficiency virus infected travelers is becoming increasingly specialized. Previous studies have reported the experience of HIV-infected travelers from temperate-climate countries but little is known about HIV-infected travelers from tropical countries. A retrospective study was conducted on HIV-infected travelers presenting at a travel health clinic in Rio de Janeiro. Eleven journeys by ten people were recorded. Brazil (Amazon region and Northeast) was the destination for six journeys. Other destinations were Peru, Angola, Europe and Asia. Nine attendees were undergoing antiretroviral therapy. Few HIV-infected people from Rio de Janeiro consulted a travel medicine specialist before traveling. Since they travel to destinations in Brazil and abroad where there are endemic diseases not encountered in Rio de Janeiro, careful pre-travel planning needs to be undertaken. Strategies for increasing the frequency of pre-travel consultations need to be developed, such as closer collaboration between HIV clinics and travel health clinics.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Viagem/estatística & dados numéricos , Adulto , Brasil , Meio Ambiente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vacinas/administração & dosagemRESUMO
Counseling for human immunodeficiency virus infected travelers is becoming increasingly specialized. Previous studies have reported the experience of HIV-infected travelers from temperate-climate countries but little is known about HIV-infected travelers from tropical countries. A retrospective study was conducted on HIV-infected travelers presenting at a travel health clinic in Rio de Janeiro. Eleven journeys by ten people were recorded. Brazil (Amazon region and Northeast) was the destination for six journeys. Other destinations were Peru, Angola, Europe and Asia. Nine attendees were undergoing antiretroviral therapy. Few HIV-infected people from Rio de Janeiro consulted a travel medicine specialist before traveling. Since they travel to destinations in Brazil and abroad where there are endemic diseases not encountered in Rio de Janeiro, careful pre-travel planning needs to be undertaken. Strategies for increasing the frequency of pre-travel consultations need to be developed, such as closer collaboration between HIV clinics and travel health clinics.
O aconselhamento para os viajantes infectados pelo vírus da imunodeficiência humana está se especializando cada vez mais. Estudos prévios relatam a experiência dos viajantes infectados pelo vírus da imunodeficiência humana dos países de clima temperado, mas pouco se sabe sobre os viajantes infectados pelo vírus da imunodeficiência humana dos países tropicais. Foi realizado um estudo retrospectivo dos viajantes infectados pelo vírus da imunodeficiência humana que consultaram um serviço de medicina de viagem no Rio de Janeiro. Dez viajantes realizaram onze viagens. O Brasil (Amazônia e Nordeste) foi o destino de seis viagens. Outros destinos foram Peru, Angola, Europa e Ásia. Nove pacientes estavam sob terapia anti-retroviral. No Rio de Janeiro, poucas pessoas infectadas pelo vírus da imunodeficiência humana consultaram um especialista em medicina de viagem antes de viajar. Como elas viajam para destinos no Brasil e no exterior aonde existem doenças endêmicas não encontradas no Rio de Janeiro, deve-se realizar um planejamento cuidadoso antes da viagem. Devem ser desenvolvidas estratégias para aumentar a freqüência das consultas pré-viagem, como, por exemplo, uma colaboração mais próxima entre as clínicas de vírus da imunodeficiência humana e de medicina de viagem.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aconselhamento Diretivo/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Infecções por HIV , Viagem/estatística & dados numéricos , Brasil , Meio Ambiente , Estudos Retrospectivos , Vacinas/administração & dosagemRESUMO
This study analyzes the prevalence of health counseling related to physical activity among users of primary health care, and explores the associated variables. This cross-sectional study included a random sample of 4,060 adults and 4,003 older adults living in areas covered by primary health care in 41 cities from seven States of South and Northeast Brazil. Prevalence of counseling for physical activity was 28.9% (95%CI: 27.3-30.4) for adults and 38.9% (95%CI: 37.3-40.6) for elders. Prevalence was consistently higher among older adults, in the Northeast, and in areas covered by the Family Health Program. Gender, socioeconomic status, smoking, sedentary lifestyle, self-reported chronic non-communicable diseases, and continuous-use medication were also associated with the outcome. Counseling for physical activity at community health centers is under-promoted, considering individual needs for healthy living. There is a need to improve participation by health professionals from different fields to promote physical activity and other healthy behaviors.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Educação em Saúde/métodos , Atividade Motora , Atenção Primária à Saúde , Adulto , Distribuição por Idade , Idoso , Brasil , Doença Crônica/reabilitação , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fumar , Fatores SocioeconômicosRESUMO
O estudo descreve a prevalência de aconselhamento educativo à saúde relacionado à atividade física entre as pessoas que utilizaram alguma vez na vida uma unidade básica de saúde, e verifica alguns fatores associados. Estudo com delineamento transversal e amostra aleatória de indivíduos adultos (N = 4.060) e idosos (N = 4.003), moradores em áreas de abrangência de unidades de saúde, em 41 municípios de sete estados das regiões Sul e Nordeste do Brasil. A prevalência de aconselhamento relacionado à atividade física foi de 28,9 por cento (IC95 por cento: 27,3-30,4) entre os adultos e de 38,9 por cento (IC95 por cento: 37,3-40,6) entre os idosos. A prevalência do desfecho foi sempre maior entre os idosos na região Nordeste, e nos adultos e idosos atendidos pelo Programa Saúde da Família. Sexo, padrão de consumo sócio-econômico, tabagismo, sedentarismo, diagnóstico médico de doenças crônicas e uso de medicação contínua também estiveram associados ao desfecho. O aconselhamento à prática de atividade física nas unidades básicas de saúde foi pouco utilizado frente às necessidades dos indivíduos, principalmente em termos de estimular hábitos de vida saudáveis. É necessário melhorar a participação dos profissionais das diferentes áreas do conhecimento na condução de aconselhamentos em saúde.
This study analyzes the prevalence of health counseling related to physical activity among users of primary health care, and explores the associated variables. This cross-sectional study included a random sample of 4,060 adults and 4,003 older adults living in areas covered by primary health care in 41 cities from seven States of South and Northeast Brazil. Prevalence of counseling for physical activity was 28.9 percent (95 percentCI: 27.3-30.4) for adults and 38.9 percent (95 percentCI: 37.3-40.6) for elders. Prevalence was consistently higher among older adults, in the Northeast, and in areas covered by the Family Health Program. Gender, socioeconomic status, smoking, sedentary lifestyle, self-reported chronic non-communicable diseases, and continuous-use medication were also associated with the outcome. Counseling for physical activity at community health centers is under-promoted, considering individual needs for healthy living. There is a need to improve participation by health professionals from different fields to promote physical activity and other healthy behaviors.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aconselhamento Diretivo/estatística & dados numéricos , Educação em Saúde/métodos , Atividade Motora , Atenção Primária à Saúde , Distribuição por Idade , Brasil , Estudos Transversais , Doença Crônica/reabilitação , Estilo de Vida , Fumar , Fatores SocioeconômicosRESUMO
OBJECTIVE: The authors reviewed demographic and clinical characteristics of undergraduates at a Brazilian public university (UNICAMP) who visited the campus mental health service (SAPPE) and compared their demographics with those from all undergraduate students enrolled in the university. PARTICIPANTS: The authors looked at data from all undergraduates who sought counseling or mental health care at SAPPE over a 17-year period (N = 2,203; 1987-2004). METHODS: They obtained this information from clinical charts and a UNICAMP database. RESULTS: Women, students from other Brazilian states, students living in the campus residence hall, and students whose main source of income was a scholarship were overrepresented. Female student-clients complained about family conflicts more frequently than did their male counterparts, and male student-clients reported concern about poor academic performance more frequently than did their female counterparts. CONCLUSIONS: Sex, living in a university residential facility, and reliance on a scholarship grant were predictive of undergraduates' mental health-seeking behavior and pattern of complaints.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Transtornos Mentais/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Saúde Mental , Serviços de Saúde para Estudantes/estatística & dados numéricos , Estudantes , Universidades , Adolescente , Brasil , Coleta de Dados , Bases de Dados como Assunto , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Testes Psicológicos , Fatores Sexuais , Apoio Social , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
CONTEXT AND OBJECTIVE: Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. DESIGN AND SETTING: Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE), Universidade Estadual de Campinas (Unicamp). METHODS: The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients clinical charts. Unicamps database was consulted for general information on its students. RESULTS: The findings indicated overrepresentation, among the clients, of undergraduates, female students, students from Brazilian states other than São Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found overrepresentation of Humanities and Arts students among the clients. The most frequently reported complaints were difficulties in interpersonal relationships, family conflicts and poor academic performance. CONCLUSION: Course level (undergraduate or postgraduate), study field, living in a university residential facility and reliance on a scholarship grant were found to influence the behavior of seeking mental health counseling among Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.
Assuntos
Aconselhamento Diretivo/estatística & dados numéricos , Transtornos Mentais/psicologia , Serviços de Saúde para Estudantes/estatística & dados numéricos , Brasil/epidemiologia , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Cooperação do Paciente , Estudos Retrospectivos , Fatores Socioeconômicos , Serviços de Saúde para Estudantes/normas , Adulto JovemRESUMO
CONTEXT AND OBJECTIVE: Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. DESIGN AND SETTING: Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE), Universidade Estadual de Campinas (Unicamp). METHODS: The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients clinical charts. Unicamps database was consulted for general information on its students. RESULTS: The findings indicated overrepresentation, among the clients, of undergraduates, female students, students from Brazilian states other than São Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found overrepresentation of Humanities and Arts students among the clients. The most frequently reported complaints were difficulties in interpersonal relationships, family conflicts and poor academic performance. CONCLUSION: Course level (undergraduate or postgraduate), study field, living in a university residential facility and reliance on a scholarship grant were found to influence the behavior of seeking mental health counseling among Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.
CONTEXTO E OBJETIVO: A caracterização dos pacientes é uma etapa fundamental para a avaliação e aprimoramento dos serviços de saúde mental para estudantes universitários. Os objetivos deste estudo foram descrever as características sócio-demográficas e as queixas referidas pelos estudantes de uma universidade pública brasileira que procuraram atendimento num serviço de saúde mental para universitários por um período de 17 anos e compará-los com a totalidade dos estudantes dessa universidade. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo realizado no Serviço de Assistência Psicológica e Psiquiátrica ao Estudante (SAPPE) da Universidade Estadual de Campinas (Unicamp). MÉTODO: Os sujeitos foram 2.194 estudantes que procuraram atendimento em saúde mental no SAPPE no período de 1987 a 2004. Os dados foram obtidos a partir de seus prontuários. O banco de dados da Unicamp foi consultado para a obtenção das informações sobre os estudantes da universidade como um todo. RESULTADOS: Entre os alunos que procuraram atendimento encontramos uma sobre-representação de estudantes de graduação, do sexo feminino, procedentes de outros estados brasileiros que não o Estado de São Paulo, que moravam na moradia universitária, que tinham bolsas de auxílio como principal fonte de renda e das áreas de Humanas e Artes. As queixas mais relatadas foram: dificuldades no relacionamento interpessoal, conflitos familiares e desempenho acadêmico insatisfatório. CONCLUSÃO: O nível do curso (graduação ou pós-graduação), a área do curso, ser residente na moradia universitária e possuir bolsa de auxílio foram variáveis que influenciaram a procura de atendimento em saúde mental dos estudantes universitários brasileiros avaliados. O nível do curso influenciou o tipo de queixa referida no primeiro contato com o serviço de saúde mental.
Assuntos
Feminino , Humanos , Masculino , Adulto Jovem , Aconselhamento Diretivo/estatística & dados numéricos , Transtornos Mentais/psicologia , Serviços de Saúde para Estudantes/estatística & dados numéricos , Brasil/epidemiologia , Métodos Epidemiológicos , Transtornos Mentais/epidemiologia , Saúde Mental , Cooperação do Paciente , Estudos Retrospectivos , Fatores Socioeconômicos , Serviços de Saúde para Estudantes/normas , Adulto JovemRESUMO
Foi realizado um estudo transversal com base populacional entre os indivíduos de 20 a 69 anos, residentes na zona urbana de Pelotas, Rio Grande do Sul, Brasil. O objetivo foi avaliar o manejo da hipertensão e descrever as características dos indivíduos classificados com cuidados inadequados. Entre os 1.968 entrevistados, 380 eram hipertensos (19,3 por cento), 44,1 por cento consultaram sempre com o mesmo médico. Entre os hipertensos, 85,5 por cento eram sedentários, 48,2 por cento consumiam gordura em excesso e 47,4 por cento eram fumantes. As recomendações adequadas mais realizadas pelos médicos foram restringir o sal (98,4 por cento), interromper o consumo de bebidas alcoólicas (93,7 por cento), aconselhar dieta para emagrecer e reduzir a ingestão de gorduras (88,2 por cento), parar de fumar (73,2 por cento) e praticar atividades físicas (68,9 por cento). O manejo da hipertensão foi classificado como inadequado em 284 indivíduos (74,7 por cento; IC95 por cento: 70,4-79,1). Constatou-se maior probabilidade de manejo adequado nas mulheres, nos indivíduos a partir dos cinqüenta anos, nas pessoas pertencentes à classe econômica A e B, em não fumantes, e nos indivíduos com diabetes mellitus. Alguns achados traduziram aspectos positivos da atenção, contudo as diferenças de cuidados de acordo com a classe social evidenciaram a falta de eqüidade assistencial.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aconselhamento Diretivo/normas , Hipertensão/terapia , Educação de Pacientes como Assunto/normas , Padrões de Prática Médica/normas , Avaliação de Processos em Cuidados de Saúde/normas , Brasil , Estudos Transversais , Aconselhamento Diretivo/estatística & dados numéricos , Entrevistas como Assunto , Educação de Pacientes como Assunto/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Avaliação de Processos em Cuidados de Saúde/estatística & dados numéricos , Fatores SocioeconômicosRESUMO
A cross-sectional population-based study was carried out among individuals aged 20 to 69 years in the urban area of Pelotas, Rio Grande do Sul, Brazil. The objective was to analyze characteristics of hypertensive patients in relation to management of arterial hypertension. Among the 1,968 interviewees, 380 were hypertensive (19.3%), and 44.1% of these always consulted the same physician. Of the entire sample, 85.5% were sedentary, 48.2% showed excessive fat consumption, and 47.4% smoked. Most physicians recommend the following: lowering salt consumption (98.4%), cessation of alcohol consumption (93.7%), for losing weight, diet and consumption of low-fat food (88.2%), smoking cessation (73.2%), and physical activity (68.9%). The clinical management was classified as inadequate in 284 individuals (74.7%). Increased probability of adequate management was found among: women, individuals > 50 years, upper and middle-class patients, non-smokers, and patients with diabetes mellitus. Some findings showed positive aspects, but differences according to socioeconomic status evidenced lack of equity in care.
Assuntos
Aconselhamento Diretivo/normas , Hipertensão/terapia , Educação de Pacientes como Assunto/normas , Padrões de Prática Médica/normas , Avaliação de Processos em Cuidados de Saúde/normas , Adulto , Idoso , Brasil , Estudos Transversais , Aconselhamento Diretivo/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Avaliação de Processos em Cuidados de Saúde/estatística & dados numéricos , Fatores SocioeconômicosRESUMO
BACKGROUND: Prevention is the most cost-effective means of managing osteoporosis. However, little is known about osteoporosis-related preventive practices in Mexican-American women. We examined factors that might influence women's decision to start preventive measures for osteoporosis. METHODS: Information was gathered through a cross-sectional survey of low-income Mexican-American women who were seen at two clinics in southern Texas. RESULTS: Of the 270 participants, 37% reported calcium supplementation, and 41% reported regular weight-bearing exercise to prevent osteoporosis. Fifty (41%) of the postmenopausal women were currently using hormone replacement therapy. Only 15% of the premenopausal and 13% of the postmenopausal women recalled that their health care provider had counseled them about prevention. Multivariate analysis showed that public education, bone densitometry evaluation, knowledge of osteoporosis, and counseling were determinants of prevention. CONCLUSION: Although osteoporosis is a preventable condition, our findings suggest that the majority of Mexican-American women do not receive adequate preventive measures or counseling about osteoporosis. Furthermore, we found that their health care provider's counseling about osteoporosis was a major determinant of osteoporosis prevention in these women.