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- ItemPrevalência de depressão, falta de acesso, utilização e trajetória nos serviços de saúde por mulheres no período pandêmico(Universidade Federal do Espírito Santo, 2025-11-14) Fraga, Emily de Jesus; Co-orientador1; https://orcid.org/; https://lattes.cnpq.br/; Orientador1; https://orcid.org/; https://lattes.cnpq.br/; https://orcid.org/; https://lattes.cnpq.br/; 1º membro da banca; https://orcid.org/; https://lattes.cnpq.br/; 2º membro da banca; https://orcid.org/; https://lattes.cnpq.br/; 3º membro da banca; https://orcid.org/; https://lattes.cnpq.br/The COVID-19 pandemic has had negative impacts on the mental health of the population and altered the functioning of health services. Access to care is crucial for prognosis, affecting not only individuals' lives but also collective well-being. In this context, depression stands out as the leading cause of global disability, generating high social costs and putting pressure on health systems. Therefore, it is essential to recognize the factors 6 associated with access to health services by people with this diagnosis. Objectives: To estimate the prevalence and identify the factors associated with the diagnosis of depression and lack of access to medical care, as well as to describe the profile of health service use by women with this diagnosis during the COVID-19 pandemic in the city of Vitória (ES). Methods: A population-based cross-sectional study was conducted with 1,107 women aged 18 years or older, residing in Vitória (ES). Prevalence rates were estimated with respective 95% confidence intervals (95% CI). Bivariate analyses were performed for the three outcomes, and associations involving dichotomous outcomes were assessed using the Rao–Scott chi-square test. Poisson regression was applied to evaluate factors associated with the diagnosis of depression. Results: The prevalence of depression diagnosis was 19.0% (95% CI: 16.8 – 21.4), being more than three times higher among women with negative self-rated health (PR: 3.84; IC95% 2.68-5.50). It was also higher among those without a partner (PR: 1.65; IC95% 1.30 - 2.09) and among those with private health insurance (PR: 1.78; IC95% 1.40 - 2.26). Lack of access to medical care was 4.8% (95% CI: 2.2 - 10.0), with higher proportions among women belonging to economic class D/E (33.3%; 95% CI: 8.4 - 73.1), with low education (25.0%; 95% CI: 6.6 - 61.0) and among those without health insurance (12.1%; 95% CI: 5.7 - 23.7). UBSs were most used among women aged 40 to 59 years (57.4%; 95% CI: 44.2 - 69.6), with elementary school education (80.0%; 95% CI: 54.9 -92.9), black (73.1%; 95% CI: 52.2 - 87.1), mixed-race (50.0%; 95% CI: 35.4-64.6), and belonging to class D/E (100%). Private clinics were more frequent among women aged 18 to 39 years (64.2%; 95% CI: 50.2–76.1), with higher education (59.7%; 95% CI: 49.4-69.2), white (71.0%; 95% CI: 60.0 - 81.0) and in class A/B (60.9%; 95% CI: 50.1 - 70.7). Conclusion: The study highlights the impact of the pandemic on the diagnosis of depressive disorders and demonstrates that sociodemographic factors influence both the occupation of spaces in society and the attention given to mental health complaints. In addition, it highlights the fundamental role of the SUS in reducing these inequalities by expanding access to health services, especially for historically marginalized groups
- ItemViolência sexual e outras violências interpessoais contra mulheres e meninas: desafios da vigilância epidemiológica no Espírito Santo, Brasil (2017–2023)(Universidade Federal do Espírito Santo, 2025-08-05) Cupertino, Edleusa Gomes Ferreira; Viana, Maria Carmen Moldes; https://orcid.org/0000-0002-0464-4845; http://lattes.cnpq.br/4338126917250074; https://orcid.org/0000-0001-9539-5997; http://lattes.cnpq.br/8443569407928883 ; Maciel, Ethel Leonor Noia ; https://orcid.org/0000-0003-4826-3355 ; http://lattes.cnpq.br/3761398932271892; Corassa, Rafael Bello ; https://orcid.org/0000-0001-9413-7400; http://lattes.cnpq.br/3152440971038382Violence against women and girls is a serious human rights violation, reflecting gender inequality and impacting the health of victims. This study aimed to understand sexual violence against women and girls in Espírito Santo by analyzing SUS reports from 2017 to 2023. This study aimed to identify, in a comparative way, the factors associated with sexual violence in relation to other types of interpersonal violence against women and girls, describing singularities and intersections between victim profiles, contexts of occurrence and temporal trends, including possible impacts of the COVID-19 pandemic in Espírito Santo, between 2017 and 2023. The methodology consisted of a serial cross-sectional study using secondary data on reports of sexual violence and other interpersonal violence against women and girls in Espírito Santo. Data were collected from the Notifiable Diseases Information System (SINAN) for 2017–2019 and from the State Health Surveillance System (e-SUS VS) for 2020–2023. The analysis period covered three years before and three years after the first case of COVID-19 in the state. The results showed that, in Espírito Santo, among the women and girls reported for sexual violence, 69.9% were Black, 54.3% were under 14 years of age, 46.3% had less than 9 years of education, and 13.2% had some disorder or disability. Furthermore, 56.8% had no partner, 11.4% were pregnant, and 2.3% had accessed legal termination of pregnancy. The majority (86.5%) lived in urban areas, 71.1% in the Metropolitan Region, and 67.1% of the cases occurred in the victim's own residence, with 42.4% being repeat cases. The perpetrators were predominantly men (91.8%) over 24 years of age (51.8%), with 19.0% suspected of having consumed alcohol prior to the incident. Poisson regression analysis (PR; 95%CI; p < 0.001) revealed a high prevalence ratio for children up to 9 years old (PR=10.84) and adolescents aged 10 to 14 years old (PR=12.30), decreasing with increasing age (15-19 years: PR=6.89; 20-29 years: PR=2.73; 30-59 years: PR=1.71), reinforcing the robustness of the associations. In conclusion, Sexual violence against women and girls in Espírito Santo presents distinct patterns associated with gender inequality, invisibility, and the heightened vulnerability of children, adolescents, pregnant women, and persons with disabilities. The findings highlight the urgent need to strengthen the Violence and Accident Surveillance System (VIVA) through improved training, human resources, integration, and data quality to enhance the response of the SUS/ES to sexual violence.
- ItemAnálise do percurso terapêutico de idosos portadores de catarata: pesquisa nacional de saúde, Brasil, 2019(Universidade Federal do Espírito Santo, 2025-10-17) Coelho, Roberta Goltara; Sarti, Thiago Dias; https://orcid.org/ 0000-0002-1545-6276; http://lattes.cnpq.br/7489127535403969; https://orcid.org/ 0000-0003-4347-0531; http://lattes.cnpq.br/8188728500963658; Rocha, Erika Maria Sampaio; https://orcid.org/ 0000-0003-4347-0531; http://lattes.cnpq.br/6148133355428388; Almeida, Ana Paula Santana Coelho; https://orcid.org/ 0000-0001-5808-5818; http://lattes.cnpq.br/2570855705420190Introduction: Cataracts are the leading cause of reversible blindness and represent a major public health challenge in Brazil. Associated with population aging and social inequalities, the disease affects millions of people and has a significant impact on the Unified Health System (SUS). There is a scarcity of national analyses focusing on the therapeutic itinerary (care pathway) for individuals with cataracts. This gap can be addressed using data from the 2019 National Health Survey (PNS). Such analyses can contribute to identifying the magnitude of the condition and the differences in access to diagnosis and surgical treatment in Brazil. Objectives: To determine the prevalence of cataract diagnosis and associated factors, as well as the indication and effective performance of corrective surgery among Brazilian residents aged 60 and over. Methods: This is a cross-sectional, population-based study using data from the 2019 National Health Survey (PNS). The prevalence rates of cataract diagnosis, surgical indication, and surgical undertaking were calculated. Crude and adjusted Prevalence Ratios (PRs) were estimated using Poisson regression with robust variance for sociodemographic and regional factors. The final sample included 22,728 older adults. Results: Among the study participants, 40.4% (95% CI: 39.7–41.1) had a clinical diagnosis of cataract. Among these, the largest proportion (83.3%; 95% CI: 82.5–84.1) received an indication for surgical treatment, which demonstrates the recognition of the therapeutic need. However, a relevant barrier was observed in access to the subsequent stage: only 73.2% (95% CI: 72.1–74.2) of individuals with an indication for surgery actually underwent the procedure. Thus, it was found that more than a quarter (26.9%; 95% CI: 25.8–27.9) of cases requiring intervention did not complete the care pathway. Final considerations: This study highlighted the high prevalence of cataracts among older adults in Brazil and the barriers to accessing surgery, marked by social and regional inequalities. The findings reinforce the need to strengthen primary care, modernize regulatory mechanisms, and expand funding for eye health to ensure equity and reduce the burden of preventable blindness in the country
- ItemAnálise do percurso terapêutico de idosos portadores de catarata: pesquisa nacional de saúde, Brasil, 2019(Universidade Federal do Espírito Santo, 2025-01-01) Coelho, Roberta Goltara; Co-orientador1; https://orcid.org/; https://lattes.cnpq.br/; Orientador1; https://orcid.org/; https://lattes.cnpq.br/; https://orcid.org/; https://lattes.cnpq.br/; 1º membro da banca; https://orcid.org/; https://lattes.cnpq.br/; 2º membro da banca; https://orcid.org/; https://lattes.cnpq.br/; 3º membro da banca; https://orcid.org/; https://lattes.cnpq.br/Introduction: Cataracts are the leading cause of reversible blindness and represent a major public health challenge in Brazil. Associated with population aging and social inequalities, the disease affects millions of people and has a significant impact on the Unified Health System (SUS). There is a scarcity of national analyses focusing on the therapeutic itinerary (care pathway) for individuals with cataracts. This gap can be addressed using data from the 2019 National Health Survey (PNS). Such analyses can contribute to identifying the magnitude of the condition and the differences in access to diagnosis and surgical treatment in Brazil. Objectives: To determine the prevalence of cataract diagnosis and associated factors, as well as the indication and effective performance of corrective surgery among Brazilian residents aged 60 and over. Methods: This is a cross-sectional, population-based study using data from the 2019 National Health Survey (PNS). The prevalence rates of cataract diagnosis, surgical indication, and surgical undertaking were calculated. Crude and adjusted Prevalence Ratios (PRs) were estimated using Poisson regression with robust variance for sociodemographic and regional factors. The final sample included 22,728 older adults. Results: Among the study participants, 40.4% (95% CI: 39.7–41.1) had a clinical diagnosis of cataract. Among these, the largest proportion (83.3%; 95% CI: 82.5–84.1) received an indication for surgical treatment, which demonstrates the recognition of the therapeutic need. However, a relevant barrier was observed in access to the subsequent stage: only 73.2% (95% CI: 72.1–74.2) of individuals with an indication for surgery actually underwent the procedure. Thus, it was found that more than a quarter (26.9%; 95% CI: 25.8–27.9) of cases requiring intervention did not complete the care pathway. Final considerations: This study highlighted the high prevalence of cataracts among older adults in Brazil and the barriers to accessing surgery, marked by social and regional inequalities. The findings reinforce the need to strengthen primary care, modernize regulatory mechanisms, and expand funding for eye health to ensure equity and reduce the burden of preventable blindness in the country.
- ItemAnálise do processo de trabalho dos enfermeiros na central estadual de transplantes no estado do Espírito Santo(Universidade Federal do Espírito Santo, 2025-03-21) Nunes, Sabrina Ferreira; Sarti, Thiago Dias; https://orcid.org/0000-0002-1545-6276; http://lattes.cnpq.br/7489127535403969; https://orcid.org/0009-0005-4804-9633; http://lattes.cnpq.br/4247284294506845; Almeida, Ana Paula Santana Coelho; https://orcid.org/0000-0001-5808-5818; http://lattes.cnpq.br/2570855705420190; Nascimento, Ariana Nogueira; https://orcid.org/; http://lattes.cnpq.br/5286353774279763Introduction: Organ donation for transplants is a relevant topic that has been increasingly gaining attention in the current healthcare landscape. In general, organ transplantation is a field with many specificities, requiring the involvement of various professionals throughout different stages of the donation process. Nurses play a prominent role in this context, as their involvement is evident throughout the entire sequence of events. Objective: The aim of this study was to identify the main problems during the organ donation process that result in the failure to complete the donation. Methodology: This is an exploratory descriptive study with a qualitative approach, using document analysis. The qualitative analysis was conducted by reviewing reports produced by on-duty nurses, with a time frame from January to July 2023. To retain information, a standardized instrument (Appendix A and Appendix B) was used, containing guiding questions that directed the recording of relevant situations for the study. The research was conducted at the State Transplant Center of Espírito Santo, and a reflective thematic analysis was performed. Results: The study identified several problems, which centered around (1) communication between professionals and services—this being the main issue, especially regarding the speed at which necessary responses were provided to close the stages of the donation process, (2) logistics for organ retrieval and transplantation execution, (3) the various conflicts that can arise between professionals and between them and the families, and (4) the clinical evolution of the donor and the quality of the organs to be donated. These issues were not prohibitive but significantly interfered with the donation process. Final Considerations: To overcome the identified challenges, an action plan is proposed, focusing on improving communication, optimizing logistics, updating protocols and procedures, managing conflicts, ensuring the quality of the organs to be donated, and providing regular training for all teams involved.