TEDE Coleção: Programa de Pós-Graduação em Enfermagem

Fatores associados à fragilidade em idosos hospitalizados: uma análise clínica e social

Thu, 21 Nov 2024 00:00:00 GMT

Título: Fatores associados à fragilidade em idosos hospitalizados: uma análise clínica e social Autor: Gonçalves, Tânia Cassiano Garcia Primeiro orientador: Ribeiro, Rita de Cássia Helu Mendonça Abstract: OBJECTIVES: To analyze frailty and its associated factors in hospitalized elderly people METHODS: Exploratory, observational, cross-sectional study, descriptive design, quantitative analytical approach with correlation between variables, aiming to quantify the strength and relationship between them. The following research instruments were applied: Participant Characterization Instrument; Subjective Assessment of Frailty; Tilburg Frailty Indicator; Scale of Independence in Activities of Daily Living – Katz; Lawton Instrumental Activities of Daily Living Scale. In the comparative analyses, the Mann-Whitney test was used to verify the difference in the scale scores between the two groups. The Kruskal-Walli’s test was used to verify the difference in the scale scores between three or more groups. RESULTS: The sample comprised 125 participants. The median age was 70, with 72 years being the median age. There was a predominance of males (53.6%). The average amount of medication used by the participants was between four and five medications. In the subjective assessment of frailty, it was noted that 75 patients (60%) were considered frail; 38 patients (30.4%) pre-frail; and 12 patients (9.6%) non-frail. On the Tilburg scale, 59 patients were considered non-frail (47.2%) and 66 were considered frail (58.2%). In the analysis of the Katz scale, only 5 patients (4%) were dependent. There was a significant correlation between frailty and functionality in the bivariate analyses, both by the Subjective Frailty Assessment scale and by the Tilburg scale. The correlation between Subjective Frailty Assessment and Katz was positive and moderate. On the other hand, the correlation between Subjective Frailty Assessment and Lawton was inverse (also moderate). There was a significant difference. Concerning the variable Diabetes Mellitus and falls; similar to the variable "Describes Health" (p <0.001). A post hoc analysis was performed in search of comparisons in pairs due to the significant difference for the variable "Describes Health". In comparison with demographic and/or clinical data, there was a difference in the Tilburg scores according to education and personal income; and the variable "Describes Health" also showed a significant difference. In the comparison of the data with the Katz scores, there was no significant difference. In the Lawton scores, differences were observed according to the variables "With whom they live", "Education" and "Describes Health". Lawton's post hoc analysis showed a difference in the "living alone" or "living with others" groups. Lawton's post hoc analysis showed a difference between “living alone” and “living with others”. As for the “Describes Health” variable, the difference between the groups was regular and good/very good/excellent. CONCLUSION: Physical frailty and its associated factors in hospitalized elderly people are prevalent and multifactorial. The study's conclusion reinforces the need for a comprehensive approach by health teams to deal with frailty, preventing its progression, or even reversing it. Identifying frailty and understanding its associated factors are fundamental for implementing health care aimed at this population; to prevent, reverse, or avoid the progression of this syndrome. Actions that can have a significant impact on the planning of health actions that will improve the quality of life of hospitalized elderly people, making the study relevant to both clinical practice and the development of health policies addressed for this population. Instituição: Faculdade de Medicina de São José do Rio Preto Tipo do documento: Dissertação

Efeitos do microagulhamento no rejuvenescimento facial

Wed, 11 Dec 2024 00:00:00 GMT

Título: Efeitos do microagulhamento no rejuvenescimento facial Autor: Matta, Pietro Ramazzini Antunes Primeiro orientador: Poletti, Nádia Antonia Aparecida Abstract: Objective: This study investigated the effects of dermal microneedling associated with the topical application of SERUM AFAC on facial rejuvenation, focusing on skin homogenization, reduction of expression lines, treatment time, participant satisfaction, and minimization of side effects. Aesthetic treatments have a significant impact on self-esteem, physical and psychological well-being, and social acceptance, making it essential to explore safe and effective techniques. Method: In this uncontrolled clinical study, an initial sample of 23 participants was conducted between July 2023 and February 2024. The participants were between 40 and 65 years old, with 50% being white and 50% non-white, with a notable presence of dentists. After excluding participants for factors such as recent use of Botox, hyaluronic acid, unprotected sun exposure, among others, eight women remained in the study. They underwent two to three microneedling sessions, followed by the application of the SERUM. Images were taken before and after the sessions to evaluate the results. A mobile application (BEAUTY SCORE 2020) was used for comparative analysis of the faces before and after the treatment. Result: Microneedling, using Dermapen and SERUM, stimulated collagen production, resulting in firmer, smoother, and rejuvenated skin. Lightening of dark circles, reduction of aging signs around the eyes, attenuation of perioral wrinkles and nasolabial fold, as well as greater definition of mouth contours were observed. These results are consistent with existing literature, which recommends between two and 12 sessions for good results. The participants did not present any damage or excessive redness on the skin during the treatment. Conclusion: Short-term treatment with microneedling and AFAC SERUM showed remarkable and visible results, with few sessions needed to achieve significant improvements, corroborating existing literature. The absence of side effects and the observed efficacy reinforce the potential of this technique as a viable option for facial rejuvenation. The technique proved to be a minimally invasive and effective aesthetic procedure, confirming the validity of the sessions performed to obtain visible results. However, the evaluation of facial improvements was challenging due to the lack of accessible and reliable tools for this purpose. Instituição: Faculdade de Medicina de São José do Rio Preto Tipo do documento: Dissertação

Uma perspectiva de rede psicométrica em ciências sociais: investigar as medidas de autoeficácia na Educação Especial

Wed, 14 Aug 2024 00:00:00 GMT

Título: Uma perspectiva de rede psicométrica em ciências sociais: investigar as medidas de autoeficácia na Educação Especial Autor: Lopes, Sônia Maria Maciel Primeiro orientador: André, Júlio César Abstract: Objective: To adapt the Self-Efficacy in Higher Education Scale (AEFS) to the context of self-efficacy in the exercise of function of Specialist Curriculum Teachers (PECs) and to investigate the psychometric properties of the adapted scale. Method: The AEFS was adapted for the special education context, generating the Self-Efficacy Scale in the Exercise of Function - Education Context (EAEF - Educ). The sample consisted of 66 PECs from the São Paulo state school system. Confirmatory and exploratory factor analyses were carried out, as well as reliability analyses using Cronbach's alpha, McDonald's omega and composite reliability indices. Results: The original factor structure of the AEFS, consisting of five factors, was not confirmed in the EAEF - Educ by means of confirmatory factor analysis. The exploratory analysis (EGA and bootEGA) indicated a five-factor solution with adequate fit indices (CFI, TLI and RMSEA) and reliability. A new nomenclature was proposed for the factors, based on the content of the items: Self-efficacy in Applying Knowledge and Professional Training; Self-efficacy in Social Interaction and Professional Development; Self-efficacy in Setting Goals and Expressing Opinions; Self-efficacy in Meeting External Demands; and Self-efficacy in Problem Solving and Resource Finding. Conclusions: The EAEF - Educ showed evidence of validity and reliability for the sample studied. The results point to directions for future studies with larger samples and in different educational contexts, as well as practical interventions aimed at strengthening the self-efficacy beliefs of CSPs. The adaptation and validation of the EAEF-Educ provides a reliable instrument for measuring self-efficacy in the exercise of functions in the education sector. By making it possible to assess this construct in curriculum specialist teachers, the study contributes to the development of strategies aimed at strengthening the self-efficacy of these professionals. Greater self-efficacy among CSPs in special education can have a positive impact on the quality of teacher training, the implementation of special educational policies and, consequently, the improvement of teaching. The results obtained provide support for institutional actions aimed at improving the performance of special education CSPs and promoting a more effective and inclusive educational environment. Instituição: Faculdade de Medicina de São José do Rio Preto Tipo do documento: Dissertação

Influência da cirurgia bariátrica na redução da morbimortalidade da COVID-19

Mon, 25 Mar 2024 00:00:00 GMT

Título: Influência da cirurgia bariátrica na redução da morbimortalidade da COVID-19 Autor: Carmo, Maurício Vecchi Primeiro orientador: Kaiser Junior, Roberto Luiz Abstract: Objective: To evaluate whether bariatric surgery reduces mortality levels from Covid-19 and prevents serious manifestations of the disease. Methods: Cross-sectional study, developed with patients treated at an Advanced Medical Center, located in the interior of the state of São Paulo, from January 1, 2018 to December 31, 2019, with obesity (n=751). The sample included patients with a Body Mass Index of 32 kg/m2 and who contracted Covid-19 before the first dose of the vaccine (n=60). Patients who died before 2019, who underwent consultation seeking revision surgery or who underwent surgery by another medical team were excluded. The patients were separated into two groups: Group 1, composed of patients who underwent consultation and subsequently bariatric surgery (n=36); Group 2, consisting of patients who underwent consultation, but were not operated on (n=24). A questionnaire was applied that assessed the presence of comorbidities related to obesity and the worsening of Covid-19, in addition to data on the clinical evolution of the disease. Information collection was carried out through medical record data, direct contact with patients via WhatsApp, and telephone calls. Online questionnaire, search for active health plan contracts and consultation of the Brazilian National Registry of Deceased Persons. Statistical analysis was performed using SPSS (Statistical Package for the Social Science) software. Categorical variables were analyzed using the Chi-square test and Fisher's Exact Test, and qualitative variables were analyzed using the Mann-Whitney Test. A significance level of 5% was considered in all tests. Results: A significant reduction in Body Mass Index was identified in patients in Group 1 (p<0.001). The most prevalent obesity-related complications in both groups were systemic arterial hypertension, dyslipidemia and diabetes mellitus. Three patients from Group 1 and one patient from Group 2 required hospital admission due to complications from Covid-19, however only one patient from Group 1 and one patient from Group 2 required intensive care. No patient underwent orotracheal intubation. Conclusion: Bariatric surgery was effective in reducing BMI and obesity-related complications, but no evidence was found of the influence of bariatric surgery on mortality and clinical conditions of Covid-19. However, it is plausible to conjecture that bariatric surgery may have an indirect effect on the clinical conditions of Covid-19 by reducing obesity-related complications. This study highlights bariatric surgery and its effect on mitigating obesity-related comorbidities and, consequently, mitigating Covid-19 complications. Instituição: Faculdade de Medicina de São José do Rio Preto Tipo do documento: Dissertação