Mestrado em Saúde Coletiva
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- 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.
- ItemUtilização de tratamentos para dor nas costas em adolescentes e jovens brasileiros(Universidade Federal do Espírito Santo, 2025-03-07) Carmo, Leonardo Alves do; Callo Quinte, Gabriella ; https://orcid.org/0000-0003-4479-2014; https://lattes.cnpq.br/; Almeida, Ana Paula Santana Coelho; https://orcid.org/0000-0001-5808-5818; http://lattes.cnpq.br/2570855705420190; https://orcid.org/0009-0006-9070-3237; https://lattes.cnpq.br/; Sarti, Thiago; https://orcid.org/0000-0002-1545-6276; http://lattes.cnpq.br/7489127535403969; Martinelli, Katrini Guidolini; https://orcid.org/0000-0003-0894-3241; http://lattes.cnpq.br/7493606113282545Background: Back pain is a prevalent condition among adolescents and young adults, leading to functional disability and reduced quality of life. Understanding the utilization of different treatments is crucial for effective healthcare strategies. Objective: To identify the utilization of various treatments for back pain among adolescents and young adults aged 15 to 23 years in Brazil. Methods: This cross-sectional study utilized data from the 2019 National Health Survey (PNS), analyzing a sample of 9,082 individuals aged 15 to 23 years. The study examined the prevalence of back pain and the utilization of treatments, including exercise, physiotherapy, medication, integrative practices, and regular healthcare follow-up. Results: The prevalence of back pain was 9.3%. The use of treatments was associated with socioeconomic factors such as age, health insurance, registration in the Family Health Strategy and self-rated health. Adolescents aged 19 to 23 years and those participating in the Family Health Strategy were more likely to use exercises, physiotherapy and acupuncture. Having a health insurance plan was positively associated with the use of physiotherapy and acupuncture. Self-rated health was associated with medical follow-up. Conclusion: The utilization of back pain treatments among Brazilian adolescents and young adults is influenced by a complex interplay of socioeconomic and health related factors. Strategies to improve access to and utilization of effective treatments should address these disparities to promote equitable healthcare.
- ItemAdversidades na infância, autoestima, sexualidade, maternidade e reprodução na adolescência(Universidade Federal do Espírito Santo, 2025-09-30) Vieira, Tónia Linette da Conceição Mendes Rafael; Santos Neto, Edson Theodoro dos; https://orcid.org/0000-0002-7351-7719; http://lattes.cnpq.br/5430137427291413; https://orcid.org/0000-0003-1961-6481; http://lattes.cnpq.br/4530700854931867 ; Portugal, Flávia Batista; https://orcid.org/0000-0002-4425-2627; http://lattes.cnpq.br/1876697154549534; Reisen, Andressa; https://orcid.org/0000-0003-3916-462X; http://lattes.cnpq.br/7553715313970938 ; Alencar, Filomena Euridice Carvalho; https://orcid.org/0000-0003-2689-4893; http://lattes.cnpq.br/1541460927486933; Bueno, George Nunes; https://orcid.org/0000-0002-2682-4214; http://lattes.cnpq.br/9461730986418352Childhood adversity is considered one of the main risk factors for the development of psychosocial problems later in life, accounting for one-third of mental disorders in people over 18 worldwide and can trigger risky sexual behaviors in adolescence. The objective of this dissertation was to analyze the relationship between childhood adversity and self esteem, Attitudes Toward Adolescent Sexuality (AFSA), perceptions about motherhood and reproduction, and economic characteristics in adolescents aged 15 to 19. This study is part of a school-based cross-sectional epidemiological survey conducted between 2016 and 2017 with a sample of 2,293 students in high schools in the Greater Vitória Metropolitan Region, Espírito Santo. To analyze AFSA and its associations, the sample consisted only of female adolescents, totaling 1,376 participants. Descriptive and inferential statistics were performed based on the survey of socioeconomic characteristics and four instruments: the Childhood Adversity History Questionnaire, the Self-Esteem Scale, the Attitudes Toward Sexuality Scale, and the Values and Beliefs Questionnaire about Sexuality and Motherhood, in adapted versions. One of the questions from the Integrated Social Capital Questionnaire was used to analyze the association between interpersonal relationships and self-esteem. Frequencies were calculated, and Pearson's chi-square test, analysis of variance (ANOVA), and multinomial logistic regression were applied. The results demonstrated that childhood adversities determine self-esteem in adolescence. Statistically significant associations were found between low self-esteem and the following childhood adversities: emotional abuse (p<0.001), physical abuse (p<0.001), sexual abuse (p<0.001), substance use in the family (p<0.001), mental illness in the family (p<0.001), physical neglect (p<0.001), and emotional neglect (p<0.001). Regarding the research on AFSA, the results demonstrated that 20% of the participants presented unfavorable AFSA and AFSA were associated with self-esteem (Orajustado = 2.008; CI95% = 1.177-3.428), socioeconomic variables: race/color (Orajustado1.261; CI95%=1.087-1.463), marital status (Orajustado = 4.037; CI95% = 1.598-10.199), and education level of the head of the family (Orajustado = 0.677; CI95% = 0.569-0.806) and with all issues related to motherhood and reproduction (p<0.05). Higher levels of education of the adolescent's head of household exert a protective effect against adverse AFSA, and friendships exert a protective effect on self-esteem. The findings showed that adolescents with low selfesteem were six times more likely to have been exposed to four or more adversities during childhood (OR=6.7; 95% CI: 1.52-29.48), while adolescents with average self esteem were more likely to have adverse AFSA. Therefore, there is a need to identify all traumatic situations experienced by children during childhood to enable early interventions to reduce risks and harm to physical and mental health in childhood and later life.