scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

2021 ◽  
Vol 25 (1) ◽  
pp. 199
Author(s):  
Xavéle Braatz Petermann ◽  
Sheila Kocourek

Este estudo teve como objetivo analisar a influência da pandemia de COVID-19 na promoção da saúde do idoso na perspectiva de trabalhadores da saúde da atenção primária. Trata de um estudo de caso, transversal e qualitativo desenvolvido em um município de pequeno porte do interior do Estado do Rio Grande do Sul. Participaram sete trabalhadores, sendo a amostra intencional, por conveniência e saturação. Os dados foram coletados mediante grupo focal e entrevistais individuais e analisados por meio da análise temática. As categorias que denotaram a influência da pandemia de COVID-19 na promoção da saúde do idoso compreenderam o distanciamento da rede de suporte social e a rede de apoio familiar. Os resultados encontrados retrataram o impacto da pandemia na vida dos idosos, em especial na saúde mental e emocional, sendo necessárias diretrizes de continuidade das ações de promoção da saúde.PANDEMIC OF COVID-19 AND HEALTH PROMOTION OF THE ELDERLY FROM THE HEALTH WORKERS PERSPECTIVEAbstractThis study aimed to analyze the influence of the COVID-19 pandemic on the promotion of elderly health from the perspective of primary health care workers. This is a case study, cross-sectional and qualitative developed in a small city in the interior of the state of Rio Grande do Sul. Seven workers participated, the sample being intentional, for convenience and saturation. Data were collected through a focus group and individual interviews and analyzed through thematic analysis. The categories that denoted the influence of the COVID-19 pandemic in promoting the health of the elderly included the distance from the social support network and the family support network. The results found portrayed the impact of the pandemic on the lives of the elderly, especially on mental and emotional health, requiring guidelines for the continuity of health promotion actions.Keywords: Health Promotion. Elderly. COVID-19. Health worker. Primary Health Care.


2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )


2020 ◽  
Vol 1 ◽  
pp. 04
Author(s):  
Giovani Sturmer ◽  
Maria Eugênia Bresolin Pinto ◽  
Monica Maria Celestina de Oliveira ◽  
Alessandra Dahmer ◽  
Airton Tetelbom Stein ◽  
...  

No Brasil, a Atenção Primária em Saúde (APS) é porta de entrada no serviço de saúde do Sistema Único de Saúde (SUS). A rede é constituída por unidades de saúde onde profissionais preparados para atuar na prevenção e manutenção da saúde da comunidade buscam atender às necessidades locais de forma equitativa, eficaz e precisa. O objetivo deste estudo é descrever o perfil dos profissionais da APS, vinculados a Especialização em Saúde da Família – UNA-SUS UFCSPA. Foi realizado um estudo transversal com profissionais da saúde não participantes do Programa Mais Médicos, que atuam na APS no Rio Grande do Sul vinculados ao curso, entre 2011 e 2013, para observar as características dos profissionais e o seu vínculo com o trabalho. Entre os 277 avaliados, a maioria são mulheres, enfermeiras, com média de 35 anos, formadas a menos de 10 anos, 88% trabalham em ESF, e 73,1% participam de equipes de saúde bucal. A pós-graduação concluída direcionada para APS foi observada em 30% dos profissionais; e 56,3% estavam no primeiro trabalho em APS, com media de 4,5 anos de atuação; 40,4% tinham outra atividade remunerada (77% médicos). Observou-se que 59% estavam satisfeitos com o tipo de vínculo, e entre a maioria foi observada a satisfação com as condições gerais de trabalho (58,1%), com a estrutura física e com os equipamentos das unidades (58,3%). Observaram-se profissionais com menor idade e pouca especialidade na área, entretanto, todos eles buscando aprimoramento através da Especialização para melhorar sua atuação na APS.Palavras-chave: Atenção Primária à Saúde. Saúde da Família. Profissionais da Saúde.ABSTRACTIn Brazil Primary Health Care (PHC) is the gateway to health service of the Unified Health System. The network consists of health unit where professionals seek to meet local needs fairly and effectively, and it must rely on trained professionals to work in community health prevention and maintenance. The aim of this study is to describe the profile of PHC professionals who are linked to UNA-SUS–UFCSPA’s Specialization Program in Family Health. A cross-sectional study with health professionals who work in PHC in Rio Grande do Sul and were linked to the program between 2011 and 2013 was conducted to observe the characteristics of professionals and their relationship with work. Among the participants (277), the majority are women, nurses with an average of 35 years, professionals for less than 10 years, 88% work in FHS, and 73.1% with oral health team. The completed a graduate degree focused on PHC was observed in 30% of the professionals; 56.3% were working their first job in PHC, with a median of 4.5 years of operation; and 40.4% engaged in another paid activity (77% physicians). It was observed that 59% were satisfied with their type of employment, and most participants showed to be satisfied with their general working conditions (58.1%) and the physical structure and equipment of the health unit (58.3%). Younger professionals and with little expertise in the area were observed, however all of them were seeking development through Specialization to improve their performance in PHC.Keywords: Primary Health Care. Family Health. Health Personnel.


2018 ◽  
Vol 9 (3) ◽  
Author(s):  
Rafael Soder ◽  
Isabel Cristine Oliveira ◽  
Luiz Anildo Anacleto Da Silva ◽  
José Luís Guedes Santos ◽  
Caroline Cechinel Peiter ◽  
...  

Objetivo: Analisar os desafios da gestão do cuidado na atenção básica a partir da perspectiva da equipe de enfermagem. Método: Estudo descritivo-exploratório de abordagem qualitativa. Os dados foram coletados por meio de entrevistas com 20 profissionais de enfermagem da Estratégia Saúde da Família de municípios do interior do Rio Grande do Sul e analisados mediante técnica de análise de conteúdo. Resultados: Apresentam-se três categorias: Morosidade da gestão pública; Sobrecarga de trabalho; e, Fragmentação e descontinuidade da assistência. Conclusão: Os desafios apresentados podem ser propulsores de mudanças, por meio de ações de gestão planejada desenvolvidas coletivamente, conforme a realidade de cada cenário.Descritores: Organização e Administração; Gestão em Saúde; Atenção Primária à Saúde; Enfermagem de Atenção Primária; Estratégia Saúde da Família.CHALLENGES FOR THE CARE MANAGEMENT IN PRIMARY HEALT H CARE: PERSPECTIVE OF THE NURSING TEAMObjective: To analyze the challenges for the care management in primary health care from the perspective of the nursing team.Method: Descriptive-exploratory study of a qualitative approach. Data were collected through interviews with 20 nursing professionals from the Family Health Strategy of municipalities in the interior of Rio Grande do Sul and analyzed using a content analysis technique.Results: Three categories are presented: Morosity of public management; Work overload; and, Fragmentation and discontinuance of assistance. Conclusion: The challenges presented can be drivers of change, through planned management actions developed collectively, according to the reality of each scenario.Descriptors: Organization and Administration; Health Management; Primary Health Care; Primary Care Nursing; Family Health Strategy.DESAFÍOS DE LA GESTI ÓN DEL CUIDADO EN LA ATEN CIÓN BÁSICA: PERSPECTIVA DEL EQUIPO DE ENFERMERÍAObjetivo: Analizar los desafíos de la gestión del cuidado en la atención básica desde la perspectiva del equipo de enfermería. Metodologia: Estudio descriptivo-exploratorio de abordaje cualitativo. Los datos fueron recolectados por medio de entrevistas con 20 profesionales de enfermería de la Estrategia Salud de la Familia de municipios del interior de Rio Grande do Sul y analizados mediante técnica de análisis de contenido.Resultados: Se presentan tres categorías: Morosidad de la gestión pública; Sobrecarga de trabajo; y, Fragmentación y discontinuidad de la asistencia.Conclusión: Los desafíos presentados pueden ser propulsores de cambios, a través de acciones de gestión planificada desarrolladas colectivamente, conforme a la realidad de cada escenario.Descriptores: Organización y Administración; Gestión en Salud; Atención Primaria de Salud; Enfermería de Atención Primaria; Estrategia de Salud Familiar.


2017 ◽  
Vol 34 (4) ◽  
pp. 499-511 ◽  
Author(s):  
Alice HIRDES ◽  
Maira Kelly Rosa da SILVA

Abstract O artigo discute as barreiras e os fatores facilitadores à descentralização em saúde mental por meio do apoio matricial. Trata-se de uma pesquisa qualitativa, realizada com apoiadores matriciais ‒ psicólogos e psiquiatras da região metropolitana de Porto Alegre, Rio Grande do Sul, Brasil. Os resultados evidenciam como obstáculos ao apoio matricial a não validação plena da gestão; a sobreposição das questões políticas em detrimento das técnicas; a incongruência entre os valores institucionais e os profissionais; as diferentes configurações da rede em Unidades de Saúde tradicionais e Unidades de Saúde da Família, que demandam arranjos organizacionais diferentes. Dentre os fatores facilitadores, evidenciam-se as relações personalizadas entre os apoiadores e os profissionais de referência, a disponibilidade, o comprometimento, a comunicação fluida, a corresponsabilização e a sistematicidade dos encontros. Conclui-se que, apesar dos diferentes obstáculos, a manutenção do apoio matricial decorre essencialmente da motivação dos apoiadores à descentralização em saúde mental.


2017 ◽  
Vol 70 (2) ◽  
pp. 308-316 ◽  
Author(s):  
Carlise Rigon Dalla Nora ◽  
Elma Lourdes Campos Pavone Zoboli ◽  
Margarida M Vieira

ABSTRACT Objective: to characterize the profile and describe the moral sensitivity of primary health care nurses. Method: this is a quantitative, transversal, exploratory, descriptive study. The data were collected through the Moral Sensitivity Questionnaire translated and adapted to Brazil. 100 primary health care nurses participated, from Rio Grande do Sul, Brazil. The data collection took place during the months of March and July 2016, in an online form. The analysis of the data occurred through descriptive statistical analysis. Results: the nurses had an average moral sensitivity of 4.5 (out of 7). The dimensions with the greatest moral sensitivity were: interpersonal orientation, professional knowledge, moral conflict and moral meaning. Conclusion: the nurses of Rio Grande do Sul have a moderate moral sensitivity, which may contribute to a lower quality in Primary Health Care.


2021 ◽  
Vol 1 (2) ◽  
pp. 215-222
Author(s):  
Amal A. M. Khairy ◽  
Hassan Farag

Thistudy aimed to train local primary health care teams on sound scientific techniques for schistosomiasis case-finding, recording, treatment and follow-up in the context of primary health care; involve local community members in designing and conducting epidemiological research on schistosomiasis and follow-up of positive cases in collaboration with primary health care teams; and assess the impact of this methodology on community compliance to laboratory testing and treatment, besides the impact on rates of prevalence, intensity, incidence and reinfection


2021 ◽  
Author(s):  
Marcos Pereira ◽  
Vannessa Sá ◽  
Paulo Henrique Rocha ◽  
João Pedro Oliveira ◽  
Rafael Amorim ◽  
...  

Background: Evidence from longitudinal studies points to the syndromic continuum of dementia. Individuals with mild cognitive impairment (MCI) are at increased risk of progressing to dementia over time, as well as older adults with subjective cognitive decline (SCD). Objective: To assess the impact of treating reversible causes of dementia on the outcome of patients with cognitive decline. Methods: Data were collected between 2017 and 2020 (mean follow-up = 44.52 ±6.85 months) in primary health care in Patos de Minas, MG. Subjects were screened using the MMSE, Figure Memory Test, Verbal Fluency, Clock Drawing Test, Geriatric Depression Scale, Geriatric Anxiety Inventory, and the Functional Activities Questionnaire. Results: Of 15 patients with SCD, 26.7% progressed to MCI. Of 45 patients with MCI, 13.4% progressed to dementia, 4.4% died and 26.7% regressed to SCD. Of 31 individuals with dementia, 6.5% regressed to SCD, 22.6% regressed to MCI and 19.4% died. Clinical improvement can be explained by the treatment of reversible causes, such as hypothyroidism, hypovitaminosis B12, and mood and anxiety disorders. Conclusion: Two-thirds of people who meet the criteria for MCI do not convert to dementia during the follow-up. These results reinforce the need of adequate screening and treatment of reversible causes of dementia in the primary care.


Author(s):  
Joia S. Mukherjee

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.


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