DISSERTAÇÃO DE MESTRADO - PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM

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Navegando DISSERTAÇÃO DE MESTRADO - PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM por Autor "COUTINHO, Nair Portela Silva"

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    Análise espacial dos casos e óbitos da covid-19 e sua relação com indicadores socioeconômicos e de saúde no estado do Maranhão.
    (Universidade Federal do Maranhão, 2023-04-12) ALENCAR, Larissa Karla Barros de; SOEIRO, Vanessa Moreira da Silva; http://lattes.cnpq.br/2013273011748287; CALDAS, Arlene de Jesus Mendes; http://lattes.cnpq.br/7214761052240294; CALDAS, Arlene de Jesus Mendes; http://lattes.cnpq.br/7214761052240294; SOEIRO, Vanessa Moreira da Silva; http://lattes.cnpq.br/2013273011748287; FERREIRA, Thaís Furtado; http://lattes.cnpq.br/1542923855954206; COUTINHO, Nair Portela Silva; http://lattes.cnpq.br/0041085284657642
    Introduction: COVID-19 is an infectious disease, caused by the SARS-CoV-2 virus, with high transmissibility and global distribution. Since it was first reported in the city of Wuhan, China, in December 2019, the world has been following the exponential growth of cases of the disease. Objective: To analyze the spatial distribution of COVID-19 cases and deaths in Maranhão and its relationship with socioeconomic and health indicators. Methodology: Ecological study of all cases and deaths of COVID-19 in the state of Maranhão notified until August 2022 at the Secretary of State for Health. Socioeconomic and health indicators were collected from the online sites of the Brazilian Institute of Geography and Statistics (IBGE), Institute of Applied Economic Research (IPEA) and e-Gestor Assistência Básica. The dependent variables used were: incidence, mortality and lethality of COVID-19, and the independent ones were: resident population of the municipalities of Maranhão, Gini Index, Municipal Human Development Index (MHDI), Social Vulnerability Index (SVI), income per capita, proportion of poor people, household crowding, illiteracy rate of people aged 15 years or over, proportion of households with a general water network, unemployment rate of the population aged 18 years or over and coverage of Primary Care (AB). The incidence, mortality and lethality rates of the 217 municipalities in Maranhão were estimated. The Global Moran Index (I) was used to assess the existence of spatial autocorrelation with the dependent variables, and the Local Moran Index to identify high and low risk areas (clusters). The maps were made using the QGIS software version 3.12.0. To calculate the global spatial autocorrelation indices, as well as the regression models, the GeoDa software, version 1.14, was used. Result: Until August 31, 2022, 468,943 cases and 11,524 deaths from COVID-19 were reported in Maranhão. The municipality of São Luís registered the highest number of cases and deaths, with 73,218 (15.61%) and 2,873 (24.93%), respectively, and the municipality of Boa Vista do Gurupi registered the lowest number, 16 cases (0.003 %). The municipality of São Francisco do Brejão did not record a death from COVID-19. The highest incidence rate was recorded in the municipality of Lagoa do Mato (25,957.44/100,000 inhab.) and the lowest rate was in Boa Vista do Gurupi (188.36/100,000 inhab.). The highest mortality rate was recorded in Imperatriz (374.25/100,000 inhab.) and the highest lethality rate was in Boa Vista do Gurupi (31.25%). The Moran I Index showed positive spatial autocorrelation for incidence, mortality and lethality in the studied period, making it possible to identify clusters of high and low risk for the dependent variables. The Ordinary Least Squares Estimation (OLS) regression model confirmed spatial autocorrelation with the dependent variables. Incidence showed a positive association with the Gini Index and AB coverage, and a negative association with IVS, MHDI and proportion of poor people. Mortality was positively associated with the Gini Index and illiteracy rate and negatively associated with the proportion of poor people and IVS. Regarding lethality, there was a positive correlation with household crowding and a negative correlation with primary care coverage and illiteracy rate. Conclusion: The spread of COVID-19 occurred heterogeneously, with wide variation between the municipalities of Maranhão, making it possible to identify areas of greater and lesser risk for the disease. Socioeconomic and health indicators influenced the evolution of the pandemic, and that such characteristics should be considered in the formulation of public policies to control the disease, as well as to reduce existing inequalities in the State.
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    AVALIAÇÃO DA ATENÇÃO À PESSOA PORTADORA DE DOENÇA RENAL CRÔNICA NA ATENÇÃO BÁSICA À SAÚDE NA PERSPECTIVA DE USUÁRIOS, FAMILIARES E PROFISSIONAIS DE SAÚDE
    (Universidade Federal do Maranhão, 2017-10-13) FREITAS, Maria de Jesus Rodrigues de; LAMY, Zeni Carvalho; 128326933-34; http://lattes.cnpq.br/9896819318523369; LAMY, Zeni Carvalho; 128326933-34; http://lattes.cnpq.br/9896819318523369; PACHECO, Marcos Antônio Barbosa; http://lattes.cnpq.br/2293822271258933; SERRA, Jacira do Nascimento; http://lattes.cnpq.br/4831631346909667; COUTINHO, Nair Portela Silva; http://lattes.cnpq.br/0041085284657642; COIMBRA, Liberata Campos; http://lattes.cnpq.br/9128715784318958
    Introduction: Chronic Kidney Disease is a serious public health problem. Diabetes Mellitus and Arterial Hypertension are the main causes of the disease, easily diagnosed and treated by programs used in public health. Primary Health Care is the level of preferential attention to promote prevention and early diagnosis of cases of the disease. Objective: To evaluate the attention given to the person with Chronic Renal Disease in Basic Health Care from the perspective of patients, family members and health professionals. Methodology: Qualitative evaluation research performed in households of patients with Chronic Renal Disease, hemodialysis units and Basic Health Units of Belém-Pará. Participants were patients with chronic kidney disease, older than 19 years old, diabetic and hypertensive, living in Belém and who undertook hemodialysis in 2015, through the Unified Health System; family members indicated by the patients; physicians and nurses of Primary Health Care. In the analysis, the technique of Content Analysis in the Thematic modality was used. Results: The first article evaluated the Trajectories of Care of Chronic Renal Disease patients, seeking to identify the functions of Primary Health Care. Three Trajectories were identified: 1) Did not seek the Basic Health Unit; 2) He sought the Basic Health Unit, but did not receive the diagnosis; 3) Received a diagnosis in the Basic Health Unit and was referred to the specialty. The second article evaluated the attention given by the Basic Health Care to people with Chronic Kidney Disease, from the perspective of the interviewees, whose analysis resulted in two categories: 1) Primary Care is the place of people with Chronic Disease? (Distrust in Primary Care, Primary Care does not deal with Chronic Kidney Disease, Indifference of the multiprofessional team, Ineffectiveness in communication in the care network); 2) Basic Health Care loses contact with users on hemodialysis treatment. Conclusion: The care trajectories revealed irregular flows of care in the care network. Patients and their families did not perceive Basic Health Care as a place of care. For most professionals, Basic Health Care did not perform its function as coordinator of care, did not identify Chronic Kidney Disease and did not guarantee the maintenance of the link after starting treatment.