Methodological education and care strategies in basic health care

This paper discusses methodological and care strategies or tools used in basic health care practice. It is based on the dialogue established between what we think and what we carry out at the Life Quality Promotion Outpatient Centers (APQVs). These centers are located at two basic health care centers in Porto Alegre/RS, Brazil. Its users are mostly adult and elderly patients with long-term illnesses. The proposal of this discussion arose from a research project financed by the Brazilian Council for Scientific and Technological Development--CNPq, and integrates a thematic network called Education and Care Methodologies to Promote Life Quality. Starting from this empirical and conceptual base, methodological tools were built to develop nursing consulting services in outpatient health care to individuals and groups. This article aims to present relational and operational concepts used in care at these services.     

Popular wisdom and scientifism in "family health" strategy: complementarity ou exclusion?

The "Family Health" Strategy has been created to replace the traditional model of healthcare. It assumes the integration of subjective and social dimensions of users, overcoming the reduction of the health/disease process to pure technical-scientific limits. The scope of this article is to understand how the health professionals deal with popular wisdom of the Family Health Strategy users. The methodology is explanatory with a qualitative approach, using the focal group as a technique for the collection of data, and content analysis for interpretation of the results. The sample is formed by participants of the seven teams of the Family Health Strategy of the municipality of Campo Bom State if Rio Grande do Sul, chosen according to criteria of competences, totaling twelve members. The results present divergences between professionals about accepting or not accepting popular wisdom. Many do not consider the subjectivity and the social representations of popular culture in the health/disease process. Others only tolerate this knowledge as a strategy to make the users accept the proposed therapy. However a minority values this knowledge as complementary to the scientific universe, in the construction of a comprehensive approach.     

Loneliness as a gender-specific predictor of physical and mental health-related quality of life in older adults

Quality of Life Research - Health-related quality of life (HRQOL) in older persons is influenced by physical and mental health, as well as by their social contacts and social support. Older women...     

The hidden face of AIDS in Brazil

The authors report on the evolution of the AIDS epidemic in Brazil from the point of view of the construction of social representations about "risk groups" involved in the spread of the disease. They emphasize the need to demystify the immediate correlation between AIDS and homosexual transmission. They highlight the role of intravenous drug users and of heterosexual transmission in new AIDS cases in Brazil - groups and behaviours that are not included in the priorities of local health authorities.     

Health-related quality of life and associated factors among patients with epilepsy at the University of Gondar comprehensive specialized hospital,northwest Ethiopia

Quality of Life Research - Epilepsy is a global public health problem that causes a profound physical, psychological and social consequences. However, as such evidence in our country is limited,...     

心理健康促进疗法对恢复期精神分裂症患者社会功能和生活质量的影响

目的探讨心理健康促进疗法对恢复期精神分裂症患者社会功能和生活质量的影响。方法在药物维持治疗的同时,对照组72例精神分裂症恢复期患者给与一般心理支持治疗,观察组72例患者在此基础上实施心理健康促进疗法。两组患者分别于入组时、24周时用社会功能缺陷筛选量表(SDSS)、康复状态量表(MRSS),生活质量综合评定问卷(GQOLI)进行社会功能和生活质量的评定。结果入组时两组间SDSS MRSS GQOLI评分比较差异无显著性(P0.05)。24周时SDSS MRSS GQOLI评分与对照组比较,差异有显著性(P0.01)。结论心理健康促进疗法能有效地改善恢复期精神分裂症患者的社会功能和生活质量。     

Assessing the relationship between adverse childhood experiences and life satisfaction,psychological well-being,and social well-being: United States Longitudinal Cohort 1995–2014

Quality of Life Research - More than half of the U.S. population has experienced adverse childhood experiences (ACE), which are linked to physical and mental health issues. This study examines the...     

The use of medication in the perception of users Hiperdia Program

This article discusses the question of access to medication as a social right, investigating how users registered in the Hiperdia program perceive their access to medication. To achieve this, the process of "medicalization" experienced by Brazilian society today was assessed, highlighting the influence that this process has on access to medication, prejudicing the achievement of universal and equalitarian access. Using a technique recommended by qualitative research, focal groups with Hiperdia users in the basic health service of Juiz de Fora, Minas Gerais, Brazil, were set up. The survey emphasizes the perception that these users have with respect to their rights related to essential medication. In this process, their beliefs, knowledge, attitudes, difficulties, fears, doubts and anxieties concerning the use of essential medication are investigated, as well as their viewpoints on the disease(s) they suffer from. Among the results obtained, it was revealed that the majority of the users of basic health units do not consider that they have rights and that access to medication as a constitutionally-assured social right is far from being implemented in the Brazilian public health service today.     

Health education and social representation: an experience with the control of tegumentary leishmaniasis in an endemic area in Minas Gerais, Brazil

This study was developed in an endemic area of tegumentary leishmaniasis in Minas Gerais, Brazil, with the objective of analyzing a health education process based on the social representations theory. The educational model was developed in two phases with 34 local residents. In the first phase, social representations of leishmaniasis were identified and analyzed. The second phase was based on the interaction between social representations and scientific knowledge. The results showed that social representations were structured in a central core by the terms "wound" and "mosquito" and in the peripheral system by the terms "mountains", "standing water", and "injection" related respectively to place, transmission, and treatment of the disease. We concluded that tegumentary leishmaniasis is viewed as a wound caused by a mosquito, portrayed by metaphors. The results of the second phase showed that social representations are systems that favor adherence to scientific knowledge, at times more rigidly in the central core, other times more flexibly when linked to the peripheral systems.     

生命质量评价在职业流行病学中的应用

生命质量的测定方法分为访谈法、观察法、主观报告法、症状定式检查法、标准化的量表评定法等,根据人群、疾病种类和测定目的不同选用不同的测定量表.生命质量评价为职业流行病学研究提供了一种新的研究手段,用生命质量评价方法可全面考虑尘肺等职业病及职业性皮炎等其他工作相关疾病对患者造成的躯体、心理和社会影响,也可以对职业人群的健康状况作出全面的评价,探讨影响职业人群生命质量的因素,全面评价医疗保健措施的效果,保护重点人群,为采取有效的重点防治措施提供了新的科学依据.     

Depression and suicidal ideation: association of physical,mental, social,and spiritual health status

Quality of Life Research - The aim of this study was to determine if multidimensional (physical, mental, social, spiritual) health status could predict the presence of depressive symptoms and...     

Making sense of unfamiliar risks in the countryside: the case of Lyme disease

The focus of this paper is on how popular representations of the countryside provide countryside users with a discursive framework to make sense of unfamiliar countryside-based risks, taking Lyme disease as an example. Sixty-six semi-structured interviews were conducted with 82 visitors in Richmond Park, New Forest, and Exmoor National Park in the UK. The data were analysed using thematic analysis and was informed by social representations theory. The analysis indicated that a lay understanding of the risk of Lyme disease was filtered by place-attachment and the social representations of the countryside. Lyme disease was not understood primarily as a risk to health, but was instead constructed as a risk to the social and restorative practices in the context of the countryside. The findings suggest that advice about zoonoses such as Lyme disease is unlikely to cause panic, and that it should focus on the least intrusive preventative measures.     

短程结构式游戏治疗对社交焦虑儿童的干预研究

目的 探讨对社交焦虑儿童进行短程结构式游戏治疗的疗效,为社交焦虑儿童的干预提供依据。方法 将23名社交焦虑儿童随机分为实验组(n=12)和对照组(n=11),对实验组儿童给予10次短程结构式游戏治疗进行干预,采用儿童社交焦虑量表(Social Anxiety Scale for Children,SASC)、心理健康诊断测验(Mental Health Test ,MHT)、儿少主观生活质量问卷(Inventory of Subjective Life Quality,ISLQ)进行疗效评估。 结果 治疗后,实验组儿童在SASC量表各因子分和总分均明显低于对照组儿童(P<0.01);在MHT量表的学习焦虑、对人焦虑、孤独倾向、自责倾向、过敏倾向、身体症状、冲动倾向得分和总分均低于对照组(P<0.01或<0.05);在ISLQ的同伴交往、学校生活、焦虑体验维度得分和总分均高于对照组(P<0.01或<0.05)。 结论 短程结构式游戏治疗对社交焦虑儿童的近期疗效肯定。     

International quality of life assessment (IQOLA) project

The International Quality of Life Assesment (IQOLA) Project is a 4-year project to translate and adapt the widely used MOS SF-36 Health Survey Questionnaire in up to 15 countries and validate, norm, and document the new translations as required for their use in international studies of health outcomes. In addition to the eight-scale SF-36 health profile, the project will also validate psychometrically based physical and mental health summary scores, as well as health utility indexes incorporating SF-36 scales for use in cost-utility studies.Supported by Glaxo Inc., Research Triangle Park, North Carolina, USA, and Schering-Plough Corporation, Kenilworth, New Jersey, USA.     

Quality of Working Life Issues of Employees with a Chronic Physical Disease: A Systematic Review

Purpose To assess issues that contribute to the Quality of Working Life (QWL) of employees with a chronic physical disease. Methods A systematic literature search was conducted using the databases PubMed, PsycINFO and EMBASE. Experiences and perceptions during the working life of employees with a chronic physical disease were extracted and synthesized into issues that contributed to their QWL. We organized these synthesized QWL issues into higher order themes and categories with qualitative data analysis software. Results From a total of 4,044 articles identified by the search, 61 articles were included. Data extraction and data synthesis resulted in an overview of 73 QWL issues that were classified into 30 themes. The following five categories of themes were identified: (1) job characteristics with issues such as job flexibility and work-site access; (2) the social structure and environment containing issues about disclosure, discrimination, misunderstanding, and awareness by employers or colleagues; (3) organizational characteristics with issues such as requesting work accommodations; (4) individual work perceptions including issues about enjoyment and evaluating work or life priorities; and (5) effect of the disease and treatment including issues about cognitive and physical health and work ability. Conclusion This systematic review offers an extensive overview of issues that might contribute to the QWL of employees with a chronic physical disease. This overview may function as a starting point for occupational support, such as monitoring and evaluating the QWL of employees with a chronic physical disease during return-to-work and work continuation processes.     

Representaciones sociales sobre la salud y la enfermedad de la población adulta de Guadajalara,México

ObjectiveThe aim of the study was to identify the content and the organization of social representations on health and disease of an adult population of Guadalajara, Mexico, and to describe differences between the points of view of men and women.MethodologyThe methodology was structured focus groups of the social representations: associative methods of open listing and paired comparisons were used. The participant population was men and women of Guadalajara city, Mexico. They were selected by purpose sampling. The final analysis generates graphs of words on social representations organization of health and disease concepts.ResultsThe health concept had a holistic vision; including physical, emotional and spiritual aspects. Cleaning and to have a job is fundamental for prevention of disease. Men emphasise not having bad habits and women great interpersonal relationships. The disease concept includes biological and social points of view, such as physical deficiency, altered emotional status, the treatment and care of disease. Men emphasised the economic expense of medical care, and the women, the physical exhaustion of caring for sick people.ConclusionThe proposals for the health educational practice are the inclusion of the gender point of view, respect for religious beliefs, emotional control and integral care.     

Comparing discriminative validity between a disease-specific and a general health scale in patients with moderate asthma

Health-related quality of life scales such as the Asthma Quality of Life Questionnaire and the Medical Outcomes Study Short-form General Health Survey SF-36 have become important measures of health status in clinical asthma trials. The discriminative properties of these scales, however, have not been extensively evaluated and compared. The purposes of this study were to assess and compare scale and discriminative properties of the Asthma Quality of Life Questionnaire (AQLQ) and the SF-36 in a group of patients with moderate asthma using a patient-rated global measure of disease activity as the criterion variable. Patients were interviewed in-person with a series of questionnaires including the AQLQ and the SF-36, and were also asked the global question "How active is your asthma now?" with possible responses of "extremely," "very," "moderately," "mildly" or "not active." Discriminative properties were determined using receiver operating characteristic (ROC) curves with responses to the global question as the criterion variable and mean domain scale scores as the independent variables. Relative validities for the AQLQ and SF-36 domains were also compared. A total of 230 patients, mean age of 41 years, were enrolled. Scores were lower and ranges were narrower for the AQLQ compared to the SF-36. In general, the AQLQ and the SF-36 were highly correlated, with r = 0.69 for the AQLQ overall score and the SF-36 Physical Component Summary (PCS) score. According to ROC analyses, both scales had excellent discriminative properties; however the area under the ROC curve was higher for the AQLQ overall score (0.81) than for the PCS (0.75). When ranked according to ROC area, the symptoms domain (0.83) had the greatest area under the ROC curve, followed by the emotional (0.76) and activities (0.76) domains of the AQLQ. However, in some cases, the area under the curve was less for an AQLQ domain (for example, 0.71 for the environmental domain) than for SF-36 domains (for example, 0.75 for the role physical, and 0.75 for the social domain). Similarly, the AQLQ overall had a higher relative validity (5.2) compared to the PCS (2.2), and the symptoms domain of the AQLQ had the highest relative validity (6.0). Thus, both the Asthma Quality of Life Questionnaire and the SF-36 were able to characterize patients with moderate asthma in our cross-sectional study. In addition, both scales had strong discriminative properties when assessed with a global patient rating of current disease activity.     

Oral conditions and quality of life

Oral conditions can have serious, disabling effects. The purposes of this study are 2-fold: first to estimate the prevalence and severity of self-reported oral problems in male veterans who use Department of Veterans Affairs (VA) outpatient medical (but not dental) care and, second, we examine to what extent the impact of oral conditions is associated with measures of general health and well-being. Male veteran users of outpatient VA medical care from the Veterans Health Study (N = 2425) were surveyed using questionnaires, which included sociodemographic information, the SF-36, the Geriatric Oral Health Assessment Index (GOHAI), and the Oral Health and Quality of Life (OHQOL) measure. Only 28% of these users of VA outpatient care rated their oral health as excellent or very good, 32% as good, and nearly 40% as fair or poor. Furthermore, only one half of respondents could always eat without discomfort, were pleased with the looks of their teeth, and had no worries about their teeth. Factor analysis of the SF-36, GOHAI, and OHQOL items confirmed that both the GOHAI and the OHQOL are separate and independent of the 8 scales of the SF-36. Regression analyses showed that the GOHAI but not the OHQOL is significantly associated with the mental and physical component summary scales of the SF-36 when both sociodemographics and disease burden are controlled for in the models. Oral problems, as measured by the GOHAI and the OHQOL, are significant burdens on the health and function of veterans who use VA outpatient care. Oral health, as measured by the GOHAI, contributes in an important way to the functional well-being of users of VA healthcare.     

Health-related quality of life and the transformation of symptoms

This paper traces the development of health-related Quality of Life instruments over the last half century. It identifies the emergence of key components of quality of life measurement in other health status questionnaires between about 1950 and 1980 and their formalization in Quality of Life instruments in the mid 1980s. The common developmental thread that linked these Quality of Life instruments and their precursors was the identification of 'distal symptoms' that represented the impact of illness beyond its immediate bodily manifestations. The measurement of distal symptoms through Quality of Life instruments also served to detach symptoms from their customary patho-physiological referent. Other contemporary examples of these free-floating symptoms reinforce the argument that the nature and meaning of symptoms has been transformed over recent decades.     

Social representations of women who live with high blood pressure

The Arterial Hypertension is considered as a serious Public Health problem that affects most of the world population and presents difficulties to control.This study dealt with the social representations of the women carriers of Arterial Hypertension about what it is like to be carriers of the disease in the family context, and the health services provided by the professionals that care for them and exploring the psychosocial aspects related to their feelings and behavior that might interfere in their treatment and control of the disease. It was performed in Teresina - PI with 25 women assisted in the Health Center. The data collected was organized in a "corpus" and submitted to the ALCESTE software 4.5, which produced three initial context units, showing the manifestations and feelings of the carriers. The social representations influence the process of knowledge production and circulation that guide and define the behavior and conducts of the hypertensive disease carrier.