Mestrado em Saúde Coletiva

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    Práticas integrativas e complementares em saúde nos Centros de Atenção Psicossocial na perspectiva dos profissionais
    (Universidade Federal do Espírito Santo, 2024-12-13) Thomes, Caroline Rodrigues; Xavier, Fabiana Gonring ; https://orcid.org/0000-0002-8256-8112; http://lattes.cnpq.br/3162042983625740; Siqueira, Marluce Mechelli de ; https://orcid.org/0000-0002-6706-5015; http://lattes.cnpq.br/5309001654924097; https://orcid.org/0000-0003-3522-5368; http://lattes.cnpq.br/5159064625161423; Silva Júnior, Manoelito Ferreira ; https://orcid.org/0000-0001-8837-5912; http://lattes.cnpq.br/1260232140260557; Meyrelles, Silvana dos Santos ; https://orcid.org/0000-0003-0167-4093; http://lattes.cnpq.br/7731215198101947
    Introduction: The National Anti-Asylum Movement spurred deinstitutionalization in Brazil, solidified by Law 10216/2001, which reorients mental health care and promotes the progressive closure of asylums. In this context, Psychosocial Care Centers have emerged as strategic coordinators of the Psychosocial Care Network, integrating intersectoral resources to promote autonomy and social reintegration. Simultaneously, Integrative and Complementary Health Practices have gained prominence as complementary approaches to conventional therapies. Objective: This study aimed to understand the perspectives of professionals working in Phychosocial Care Centers and municipal managers in Vitória, Espírito Santo, regarding Integrative and Complementary Health Practices. Methods: This is an exploratory, descriptive study with a qualitative approach. The sample was determined by saturation. Semi-structured interviews were conducted with 24 professionals from Psychosocial Care Centers and four managers. The interviews were recorded, transcribed, and analyzed using Bardin´s content analysis. Results: Integrative and Complementary Health Practices are highlighted as promising tools in mental health care whithin Psychosocial Care Centers, fostering comprehensive care, user autonomy, and strengthening therapeutic bonds. Despite structural and operational challenges, their implementation enhances the psychosocial model, contributing to a more humanized Unified Health System in alignment with the principles of the Brazilian Psychiatric Reform. Conclusions: The findings indicate that Integrative and Complementary Health Practices, when integrated into Psychosocial Care Centers, strengthen the psychosocial model and contribute to more comprehensive and humanized care, these practices promote user autonomy and well-being. However, their consolidation within these settings requires joint efforts from managers, professionals, and users to expand their integration into mental health services and reinforce practices centered on comprehensive care and user well-being
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    Saúde é comida no prato : o direito humano à alimentação adequada : estudo sobre o estado do Espírito Santo
    (Universidade Federal do Espírito Santo, 2024-12-09) Gonçalves, Eduardo Boarato; Sodré, Francis ; https://orcid.org/0000-0003-4037-9388; http://lattes.cnpq.br/7744765390568573; https://orcid.org/0000-0002-1609-0632; Alpino, Tais de Moura Ariza ; https://orcid.org/0000-0001-5045-9483; http://lattes.cnpq.br/0164204629656694; Lima, Rita de Cássia Duarte ; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270
    The concept of FNS has evolved in a continuous process and has kept pace with historical changes and economic interests. In Brazil, the concept of FNS has also undergone a process of evolution and is currently recognized as the “realization of the right of all to regular and permanent access to quality food, in sufficient quantity, without compromising access to other essential needs, based on health-promoting eating practices that respect cultural diversity and are environmentally, culturally, economically and socially sustainable. Food has been included in the list of social rights since 2006. Although hunger had already been on the rise since 2019, research by the Penssan network carried out between 2020 and 2022 showed at the time that just over 40% of households had full access to food. Moderate or severe food insecurity was present in 30.7% of the households surveyed, and 15.5% of these had experienced hunger. The regression in progress between 2004 and 2013, a period related to mitigating food and nutritional insecurity and hunger in Brazil due to inequality, was due to the breakdown of social investments. Espírito Santo is among the states with the lowest food insecurity rates, with a severe food insecurity rate of only 2.2% of the population. However, according to the IBGE, more than 84,000 people do not have access to food. There are only 4 public food banks in the state; in the private sector, there is Sesc Mesa Brasil, established in 2003. There are no popular restaurants or community kitchens in the state. An analysis of the food and nutritional insecurity of families assisted by institutions referenced by the Sesc Mesa Brasil Espírito Santo Program revealed that only 9% of these families are food secure. The percentage of mild and moderate food insecurity in both was 27%, and that of severe food insecurity was 37%. Adding together the percentages of moderate and severe food insecurity reveals the reality investigated, 64% of people are under the most severe forms of food insecurity
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    O processo de institucionalização da pessoa idosa : perspectivas e desafios expressados por familiares cuidadores
    (Universidade Federal do Espírito Santo, 2024-12-05) Souza, Mateus Nague de; Andrade, Maria Angélica Carvalho; https://orcid.org/0000-0002-3690-6416; http://lattes.cnpq.br/5427520110626795; https://orcid.org/0009-0006-6517-3844; http://lattes.cnpq.br/0822161999575741; Garcia, Ana Claudia Pinheiro ; https://orcid.org/0000-0001-5559-7463; http://lattes.cnpq.br/6391903151079745; Lima, Rita de Cassia Duarte ; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270
    Introduction: According to the Brazilian Institute of Geography and Statistics, Brazil has 203.1 million inhabitants. When analysing the elderly population, it can be seen that this group would correspond to 32,113,490 million in 2022. Ageing is a continuous, universal, dynamic and progressive process that involves physiological and functional changes. Ageing involves processes of dependency that cause discomfort for the family, after all, they have to dedicate time to caring. The carer is the family member or not who instinctively, without pay, becomes responsible for the dependent individual, which generally applies to a gender issue - the female group. To help care for those who are unable to stay at home, there is the alternative of Long Stay Institutions for the Elderly, which are on the rise due to increased longevity. The facility offers housing with gerontogeriatric assistance from a multidisciplinary team prepared to care for the elderly and an adequate structure. However, the process of institutionalising the elderly is difficult because it is linked to feelings of loneliness and abandonment. Aim: to analyse the process of institutionalisation of elderly people in Long Stay Institutions for the Elderly in the state of Espírito Santo. Methodology: This is a qualitative cross-sectional study with an analytical-descriptive design. The research participants were selected using the snowball sampling technique, i.e., the initial participants referred new participants until the saturation point of 15 participants was reached. The interviews were conducted using a semi-structured script with open-ended questions. Results: During the course of the research, a book chapter was created entitled ‘Behind the scenes of the crisis of care and Long Stay Institutions for the Elderly’. Family members explained the difficulties they had in caring at home, the physical and mental strain and the damage this caused to the burden of caring. The elderly person's entry into a Long Stay Institution for the Elderly was arduous and done with caution. Most family members reported feeling well after institutionalisation and having more time to look after themselves. Others, on the other hand, did not have good experiences and had to look for another place or return to their home of origin. Discussion: Homecare needs to be well managed and shared between family members when possible. The overload of care generates exhaustion and damage to the physical and mental health of the primary carer. Long-stay institutions for the elderly are an alternative to guarantee equal or better care than at home, allowing family members to live and look after themselves. Care in these institutions is carried out by trained professionals and needs to be managed by a technical manager who, whenever possible, instructs the team and intervenes in the care to ensure quality of life for the elderly person and the family member. Final considerations: Families need to see the Long Stay Institution for the Elderly as an extension of their care and not shy away from assistance. Monitoring and evaluation of the place needs to be constant, so that in addition to care, the family bond is maintained. However, in cases of violence or any event that could harm the integrity of the elderly person, it is up to the family member to report it and, consequently, for the Public Prosecutor's Office and the Health Surveillance Agency to mobilise to guarantee the safety of institutionalised elderly people
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    Infecção pelo HPV em mulheres adultas vivendo com HIV atendidas em serviço de referência em hospital universitário no Espírito Santo
    (Universidade Federal do Espírito Santo, 2024-10-21) Rocha, Waltesia Perini; Reuter, Tânia; Miranda, Angélica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; Sarti, Thiago Dias; Silveira, Mariângela Freitas da; Boldrini, Neide Aparecida Tosato
    Introduction: human papillomavirus (HPV) has a high prevalence and persistence in women living with HIV/AIDS, increasing the risk of developing lesions on the cervix, and thus increasing the incidence of cervical cancer by up to six times compared to HIV-negative women. Understanding the clinical and epidemiological profile of these women and the diversity of HPV genotypes is essential for developing effective health policies. Objective: Our objective was to analyze the prevalence and diversity of high- and low-risk HPV genotypes, the associated risk factors and the impact of HIV immune status on cytological abnormalities. Method: a cross-sectional study was carried out with 207 HIV-positive women who underwent vaginal self-collection for HPV Real-Time Polymerase Chain Reaction (RT-PCR) analysis between May 2021 and May 2022. The study included women aged 18 to 64, with a history of sexual intercourse, without cognitive or motor deficits that prevented the study. Participants who were pregnant, hysterectomized or had cervical cancer were excluded. Prevalence was calculated and related elements were identified using adjusted analysis. Results: all samples were considered valid for HPV testing. HPV DNA was detected in 143 samples (69.1%), with a predominance of high and/or probable high risk genotypes (60.4%). Multiple HPV infections occurred in 48.8% of cases, and 94% of samples had at least one high-risk genotype. The most prevalent high-risk HPV genotypes (HPV-HR) were HPV 58 (21.7%), HPV 68 (14.5%) and HPV 52 (9.2%). In the adjusted analysis, women with detectable HIV viral load (≥20) were 1.37 (95% CI: 1.00-1.88, p=0.046) times more likely to be infected with probable high and/or high risk HPV (HPV-Pr/HPV-HR). The prevalence of cytological alterations was 8.2% (n=17) and was associated with HPV type 18, with a prevalence probability of 33.3% (PR = 5.0; 95% CI: 1.9-13.1; p=0.001), while HPV 58 was associated with a significant increase in the risk of altered cytology, with a prevalence ratio of 2.5 (95% CI: 1.0-6.3; p=0.05). Vaccination coverage with the Quadrivalent vaccine was 5.8% (n=12). In 75% of those vaccinated, other high-risk HPVs were detected, most frequently HPV 58. Conclusion: the study identified a high prevalence of HR-HPVs/PR-HPVs in women living with HIV/AIDS, especially type 58. Detectable HIV viral load was the risk factor associated with HR-HPVs/PR-HPVs infection. The results reinforce the importance of integrated health strategies, with early HIV treatment to keep viral load suppressed and reduce HPV infection. Screening with HPV genotyping and expanding vaccination coverage with the nonavalent vaccine aims to prevent pre-neoplastic and neoplastic lesions of the uterine cervix, improving the health of this vulnerable population.
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    Depressão em mulheres residentes em Vitória, Espírito Santo: Prevalência e fatores associados
    (Universidade Federal do Espírito Santo, 2024-11-19) Angarita, Daniela Marisol Pérez; Leite, Franciéle Marabotti Costa; https://orcid.org/0000-0002-6171-6972; Flor, Luisa Sorio; Miguez, Fernanda Garcia Gabira; Oliveira, Gabriela
    INTRODUCTION: Depression is a complex and multifactorial psychiatric disorder that affects people's health, well-being and quality of life, and is considered a public health problem that urgently needs to be addressed. OBJECTIVES: The general objective of this research was to analyze the symptoms of depression in women living in the city of Vitória, Espírito Santo, and the associated factors. The specific objectives were: To verify the prevalence of symptoms of depression and its association with socioeconomic, clinical and behavioral characteristics in women living in Vitória, Espírito Santo. To identify the prevalence of symptoms of depression in women with a history of intimate partner violence living in Vitória, Espírito Santo. METHOD: A population-based crosssectional study; 1086 women aged 18 or over, living in the city of Vitória, Espírito Santo (ES), located in the Southeast region of Brazil, participated in the study. To study depression (dependent variable), the Beck Depression Inventory (BDI) was used. A questionnaire was applied to study the socioeconomic, behavioral, and clinical characteristics (independent variables) and the scale on violence against women by the intimate partner, World Health Organization Violence Against Women (WHO VAW STUDY), (WHO, 2005) of the World Health Organization. The analyses were performed in the statistical program Stata version 17.0 using descriptive statistics by crude and relative frequency and their 95% confidence intervals (95% CI). Bivariate analyses were performed using Pearson's chi-square test (χ2). Poisson regression with robust variance by crude and adjusted Prevalence Ratio (PR) along with confidence intervals (95% CI). RESULTS: The prevalence of depressive symptoms was 23.9%, with higher rates in women who did not practice physical exercise (PR: 1.47; 95%CI 1.17-1.87), smokers (PR: 1.51; 95%CI 1.18-1.94), with less education (PR: 1.59; 95%CI 1.19-2.12), without religion (PR 1.47; 95%CI 1.15-1.88), with government assistance (PR: 1.41; 95%CI 1.111.80) and with a diagnosis of multimorbidity (PR: 1.60; 95%CI 1.29-1.98). It was observed that women who suffered violence throughout their lives had a 2.55-point higher prevalence of depressive symptoms (95%CI 2.01-3.23), and women who suffered violence during the Covid-19 pandemic had 2.24-point higher prevalence of depressive symptoms (95%CI 1.82-2.75) compared to those who did not suffer intimate partner violence. CONCLUSION: The analyses indicate that there is an association between depressive symptoms and socioeconomic, clinical and behavioral characteristics and intimate partner violence against women (IPV). The importance of developing actions and public policies related to the diagnosis, prevention and treatment of depression is highlighted.