Brazilian Health Professionals Research Articles

How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. https://osf.io/bhncv .

Falta de conhecimento sobre os fatores de risco não ocupacionais da dor lombar entre profissionais de saúde ocupacional brasileiros: um estudo observacional transversal

INTRODUCTION: Low back pain (LBP) is highly prevalent and is one of the main causes of disability in Brazil and around the world. LBP presents a multifactorial etiology, being extremely common in workers. OBJECTIVE: This study aimed to verify the knowledge about the LBP risk factors, beliefs and attitudes about the management of LBP among health professionals (physiotherapists and ergonomists) working in the occupational area. MATERIALS AND METHODS: A cross-sectional observational study was conducted with 81 Brazilian occupational health professionals. Participants completed an electronic questionnaire comprising professional data, sociodemographics, items about LBP risk factors, and the Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Knowledge, beliefs and attitudes were analyzed using the chi-square test for LBP risk factors and the linear regression model for health professionals' beliefs and attitudes. RESULTS: Obesity (7.4%), sitting for more than 2 hours (8.6%), physical activity (9.9%), lack of psychosocial support at work (11.1%) and consuming alcohol (37.0%) presented the lowest rate of knowledge about LBP risk factors by professionals. Items about general health showed the lowest knowledge. A balanced biomedical and psychosocial orientation of beliefs and attitudes about managing LBP was observed. CONCLUSION: Brazilian occupational health professionals lack knowledge about non-occupational LBP risk factors, especially general health status. These professionals also have balanced biomedical and psychosocial concepts in managing LBP.

Translation and cross-cultural adaptation into Portuguese-Brazil of NuHISS, Enlight, and uMARS

BackgroundEasy access to the Internet enables the creation of many online applications. In this sense, questionnaires were developed to evaluate the usability of health area online applications: the National Usability-Focused Health Information System Scale (NuHISS), the Enlight, and the User Version of the Mobile Application Rating Scale (uMARS). Those scales do not have a Portuguese (Brazil) version which is adequate to Brazil's culture. As a consequence, they can not be properly used in Brazil. ObjectiveTo translate and cross-cultural adapt the NuHISS, Enlight, and uMARS to Portuguese (Brazil). MethodsA methodological study involving the translation and cross-cultural adaptation of the questionnaires NuHISS, Enlight, and uMARS was conducted following international guidelines recommendations. The questionnaires pass trough an initial translation, translation synthesis, back translation, expert committee, and a pre-final version test. ResultsThirdy-two health professionals analyzed NuHiss, Enlight, and uMARS translated and cross-cultural adapted Portuguese (Brazil) version. There was conceptual equivalence between the translated and original versions, and no significant adaptations were needed during the translation process. 93.8% of professionals assume that the language is cohesive and 96.9% of them consider that the content is cohesive. ConclusionThe NuHISS, Enlight, and uMARS were successfully translated and cross-culturally adapted to Portuguese (Brazil) and can be properly applied in Brazil. Brazilian health professionals should use the questionnaires NuHISS, Enlight, and uMARS to evaluate health area applications usability.

Impacts of the infodemic on COVID-19 for Brazilian health professionals.

This article aims to analyze the effects of the COVID-19 infodemic from the perspective of Brazilian health workers regarding the patients, measure the impacts of fake news on health professionals, and verify the perception of health multidisciplinary teams regarding the authorities' stance. This cross-sectional study is nested in the research "Health Professionals' Working Conditions in the Brazilian Context of COVID-19". The nationwide non-probability sampling included 15,132 professionals who worked in the COVID-19 frontline in health institutions of 2,200 Brazilian municipalities. Approximately 91% of respondents believed that fake news is an obstacle in fighting the SARS-CoV-2 virus; 76.1% declared they had seen patients who expressed faith in fake news about COVID-19; 29.3% agreed that the health authorities' stance about COVID-19 was consistent and enlightening, and 62.6% disagreed about this. The respondents believe that the COVID-19 infodemic confused patients, impaired adherence to PHC measures, and stirred people's negative behavior vis-à-vis the pandemic. The lack of clarity of the authorities' stance influenced the COVID-19 infodemic process.

Validation of the regret coping scale for healthcare professionals (RCS-HCP) in portuguese for Brazil

Introduction: the assessment of the ability to cope with regret can contribute to support strategies for health professionals. However, in Brazil there are few instruments that evaluate this ability in the general context. Objective: the aim of the study was to adapt and validate the Regret Coping Scale for Healthcare Professionals (RCS-HCP) for Brazilian health professionals. Methods: in the validation, the instruments were translated, and the psychometric properties evaluated for validity and reliability. Three hundred and forty-one professionals participated, with an average age of 38.6 ± 9.2, and 87 participated in a retest survey 30 days later. Results: exploratory factor analysis showed adequacy of the structure (KMO = 0.786) composed of three factors. In the confirmation, the performance was close to acceptable. Reliability was good for the maladaptive strategies (α = 0.834) and adequate for the problem-focused strategies (α = 0.717), but slightly too low for adaptive strategies (α = 0.595). Test-retest showed lower than expected values, with a Spearman-Brown coefficient of 0.703. Conclusion: the RCS-HCP scale showed satisfactory performance in relation to the properties evaluated.

The Mastery of Competencies for the Care of LGBT+ People by Different Health Professionals

ABSTRACT This study aims to compare the mastery of competencies in assisting the LGBT+ population of Brazilian health professionals. Data collection occurred in a face-to-face and virtual manner, in the first semester of 2018. The health professionals answered a socio-demographic and functional questionnaire, in addition to the questionnaire Measurement of Training Needs for Health Care for the LGBT+ Public. The data was analyzed using Mann-Whitney and Chi-square tests. The project research was submitted to and approved by the IMED Research Ethics Committee (CAAE 69116917.6.0000.5319). The sample (n= 380) was made up mostly of psychologists (42.3%), female (81%), heterosexual (73.2%), aged between 26 and 35 years (36%), Catholic (41%), living in the south region (36.9%), and working in the profession for ten years or more (34.3%). Skills gaps on the LGBT+ theme was identified, especially in topics such as “approach to the patient’s sexuality,” “interference of religious beliefs in care,” “care with the genitalia and breast of the trans individual,” among others. Professionals trained in psychology and non-heterosexuals had a greater mastery of the theme than the others. The fragmentation of knowledge and skills hinders the full and equal access to the health system, and continued educational actions are recommended.

Triglyceride-glucose index is associated with poor sleep quality in apparently healthy subjects: A cross-sectional study.

We aimed to evaluate the association between the triglyceride glucose index (TyG index) and sleep quality and to establish a cut-off value for the TyG index based on the prevalence of subjects with insulin resistance (IR). This cross-sectional study involved Brazilian health professionals (20-59 years). A total of 138 subjects answered the Pittsburgh Sleep Quality questionnaire to evaluate sleep quality. They were categorized into two groups: good sleep quality (global score ≤ 5 points) and poor sleep quality (global score ≥ 6 points). Also, we classified the subjects as having a high (>8.08 or >4.38) or low TyG index (≤ 8.08 or ≤4.38). The majority of the subjects (70%) with high TyG index values (>8.08 or >4.38) reported poor sleep quality (p ≤ 0.001). Those with poor sleep quality had a 1.44-fold higher prevalence of IR (TyG index >8.08 or >4.38) compared to those with good sleep quality, regardless of sex, total cholesterol, LDL/HDL ratio, insulin, complement C3, CRP, and adiponectin (p ≤ 0.001). Our data showed a positive and significant association between the TyG index and poor sleep quality. Thus, these findings support the association between poor sleep quality and IR.

Use of recommended personal protective equipment among Brazilian health professionals during the COVID-19 pandemic.

The COVID-19 pandemic is one of the biggest health crises in the world and the use of personal protective equipment (PPE) is significant measures to prevent the transmission of SARS-CoV-2. However, PPE needs to be used properly by healthcare professionals. To analyze the use of PPE among Brazilian health professionals and associated factors during a period of the COVID-19 pandemic. An analytical cross-sectional study was carried out from October to December 2020. For data collection, the respondent-driven sampling technique was used, adapted for social media, with a link to an online survey form. The study considered 12,086 Brazilian health professionals. Most (69%) used PPE recommended for the care of patients with suspected or diagnosed COVID-19. Factors associated with the use of PPE were: working in an Intensive Care Unit (ICU) or in a field hospital, receiving training, being provided with sufficient, high-quality PPE by the workplace and being an odontologist compared to nursing professionals. For procedures that generate aerosols in the context of COVID-19, 54.1% of them used the recommended PPE, the associated factors were: being married or in a stable relationship compared to a single/divorced professional, working in an ICU, being offered training, providing sufficient, high-quality PPE, and being an odontologist compared to nursing professionals. For the care of patients with COVID-19, 69% of health professionals used PPE properly, and several factors interfered with the use of this equipment.

Increased use of psychoactive substances among Brazilian health care professionals during the COVID-19 pandemic

This study aimed to estimate the prevalence of increased psychoactive substance use (PSU) and associated factors among health care professionals. A cross-sectional and analytical study with 12,086 Brazilian health professionals was undertaken. An online questionnaire was used to gather data concerning sociodemographic factors, increased consumption of alcoholic beverages, tobacco, and hypnotics or sedatives during the COVID-19 pandemic. The prevalence of tobacco, alcoholic beverages, and hypnotic or sedative consumption were 17.8 %, 69.0 % and 17.1 %, respectively. Regression analyses indicated that having no religion and social isolation were associated with increased PASU during the pandemic. COVID-19 pandemic stressors may increase PASU, and increased PASU may increase the risk of substance use disorders and substance use-related chronic diseases, such as cancer.

Prevalence of neuropsychiatric symptoms in brazilian health professionals during COVID-19 pandemic

BACKGROUND: The coronavirus outbreak 2019 (COVID-19) has overloaded healthcare professionals with a significant amount of stress. OBJECTIVES: The aim of this study is to analyze demographic and sentiments in healthcare providers associated with the exposure to patients with COVID-19. METHODS: A cross-sectional study was conducted with data remotely obtained in the period between March 20, to September 20 through a project created in March 2020 named TELEPAN Saúde UFMG, which redirects healthcare workers to volunteer psychologists, psychiatrists and other professionals. Summary of the main complaint, profession, workplace, preferred time for contact and preference media for contact were obtained from each patient. Sentiments were grouped into categories. Then, an exploratory and descriptive analysis were conducted. RESULTS: The median age of patients was 36 years of age (21 to 64). Most professionals were women (85.45%) and came from primary care, emergency services, or secondary level of care (hospitals). Primary care professionals had a higher median of age, while those working on emergency establishments had the lowest. Suicidal thoughts or emergent needs were present in 7.27% of cases. Minas Gerais (southeast region) had the highest number of patients. A significant proportion of providers suffered from symptoms of anxiety and exhaustion (11.82%), followed by sadness with anxiety. Insomnia affected 17 professionals (15.45%), and fear of being infected, 8 patients (7.27%). CONCLUSIONS: Middle-aged female healthcare professionals, mainly from primary care establishments in Brazil, were the most affected workers by anxiety, exhaustion and insomnia during COVID-19 outbreak.

Competencies of health personnel for the practice of health literacy in Brazil: A Delphi consensus survey.

The aim of this study was to identify a set of competencies of health personnel for the practice of health literacy in Brazil. Scoping review and online interviews with healthcare practitioners, followed by three rounds of the modified e-Delphi method with health literacy specialists from November/2020 to March/2021. During the rounds, the items were revised, new items added for review, and their importance was rated on a five-point Likert scale in an online form. Those items that achieved a mean Likert rating of 4+ (rated important to very important) and ≥ 90.0% agreement among the experts were maintained in each round. The initial competencies list contained 30 items from the literature scoping review and online interview with 46 Brazilian healthcare practitioners. 25 experts (health personnel with publications on health literacy) were invited to participate in the e-Delphi rounds. Of the total of 56 items evaluated, 28 reached consensus among the experts. The Brazilian competencies list differed from other consensuses by the emphasis on professional commitment to the literacy in health, autonomy and social context of the patient. For the Brazilian context, 28 competencies are relevant to the practice of health literacy in health care. This study is an initial step to develop the HL competences of Brazilian health professionals and an update of the skills evidenced in previous international studies.

Psychometric Properties of the COVID-19 Burnout Scale in Brazil

The present study aims to adapt and analyze the psychometric properties (evidence of factor validity and internal consistency) of the COVID-19 Burnout Scale in a sample of Brazilian health professionals. Two studies were carried out (N total = 427). In Study 1 [202 health professionals (age over 18), mainly women (82%) and psychologists (31.2%)], an exploratory factor analysis support the one-factor solution and the suitability of the ten items. Moreover, was also presented in Study 2 [225 health professionals (over 18 years old), the majority of women (79.6%) and psychologists (24.8%)] results of confirmatory factor analysis and item parameters (Item Response Theory) that corroborate the unifactorial structure and convergent validity with the Coronavirus Anxiety Scale. The results indicate that this measure may be suitable for use in research and in the burnout evaluation scenario.

Factors associated with the diagnosis of COVID-19 among Brazilian health professionals COVID-19 and health professionals.

IntroductionHealth professionals are on the front lines against the Coronavirus 2019 (COVID-19) pandemic and are at high risk for acquiring the infection. Failures in precautionary measures, inadequacy/scarcity of Personal Protective Equipment (PPE), and lack of social and family distancing may be associated with increased exposure and contamination by the new coronavirus. This study investigated the prevalence of COVID-19 among Brazilian health professionals and associated factors according to demographic and occupational characteristics.MethodsA cross-sectional, analytical study was conducted using an online survey with 12,086 health professionals from all regions of Brazil. Data were collected using an adaptation of the respondent-driven sampling method for the virtual environment. The outcome variable was the diagnosis of COVID-19. Bivariate and multiple logistic regression analyzes were used to identify an association between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05.ResultsMost participants were female, from the northeast region, and nursing professionals. A prevalence of 31.95% (95%CI: 31.0%, 32.9%) of COVID-19 was estimated. Following multiple regression analysis, the variables associated with the diagnosis of COVID-19 among health professionals were: male gender, married individuals, professionals who provide care to patients with COVID-19, who work in a field hospital, and those who work in institutions that did not offer enough quality PPE.ConclusionsThe study found a high prevalence of COVID-19 infection, with male professionals being those with greater chances. Inadequate supply or poor quality of PPE offered by health institutions compromises the health of professionals with an increase in positive diagnosis for COVID-19.

Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide in Brazil: a Delphi expert consensus study

BackgroundSuicide is a major public health concern in Brazil, with nearly 115,000 Brazilians dying by suicide in 2010–2019. As support for individuals at risk of suicide may come from the community, particularly family and friends, it is fundamental that evidence-based programs or resources to improve such support are in place when needed. This study aimed to culturally adapt the mental health first aid guidelines for assisting a person at risk of suicide used in English-speaking countries for Brazil.MethodsA Delphi expert consensus study was conducted among a diverse range of Brazilian health professionals and individuals with lived experience of suicide (n = 60). A total of 161 items from the mental health first aid questionnaire used in English-speaking countries were translated and used in the Brazilian questionnaire. Participants were asked to rate the appropriateness of those items to the Brazilian culture and to recommend any new items when appropriate.ResultsData were collected over two survey rounds. Consensus was achieved on 145 items. While 123 out of 161 items were adopted from the English guidelines, 22 new endorsed items were created from the expert panel comments.ConclusionsEven though there were similarities among the Brazilian and English-language guidelines, the adapted guidelines incorporated actions that were specific to the Brazilian culture, such as new items emphasising the role of family and friends. Further research is warranted on dissemination and uptake of the guidelines in Brazil as well as research into incorporation of the guidelines into Mental Health First Aid (MHFA) training for Brazil.

What do Brazilian health professionals know about the frailty syndrome? A cross-sectional study

BackgroundThe growing care demand for frail older adults and those at risk of frailty in primary health care (PHC) requires professionals trained in the subject to promote adequate care. This study aimed to analyze the self-reported, theoretical and practical knowledge of PHC professionals about the frailty syndrome.MethodsThis is an observational cross-sectional study with a sample of 485 Brazilian health professionals (bachelor’s degree) working in PHC with older adults. An electronic questionnaire was used to collect data on professional characteristics and self-reported, theoretical and practical knowledge concerning frailty phenotype. Agreement analysis between types of knowledge and multivariate logistic regression were performed to show the factors associated with knowledge about frailty.ResultsTheoretical knowledge showed the worse result, with 87.5% of the professionals describing the syndrome incorrectly. Roughly half the professionals self-reported (52.6%) very little/no knowledge concerning the syndrome and demonstrated low practical knowledge (55.1%) when identifying clinical cases. There were misconceptions about the syndrome, like it is natural from the aging process (83.3%) and is synonymous with disability and comorbidity (51.2%). The majority of the professionals were unaware of instruments for assessing frailty (77.9%) and the phenotype criteria (68.2%). No agreement was observed between the types of knowledge. Professionals specialized in or who had taken training courses in older adult health were 6.1 and 2.7-fold more likely, respectively, to self-reported some knowledge on the frailty syndrome.ConclusionsPHC professionals presented little knowledge on the frailty syndrome. Most professionals were unaware of the frailty definition, its assessments for diagnosis and evidence for its treatment. The lack of knowledge on frailty could affect the care provided to older adults in primary care.

And who cares for the caregivers in times of the deadly COVID-19 pandemic in the Brazilian context?

The goal of this article is to reflect on the value that care and caring currently assumes in the context of Brazilian health professionals during the COVID-19 pandemic period. Some denialist narratives served to transform doctors and nurses into public enemies, who often began to be harassed. The collected data were based on government documents, scientific articles and current information from journalistic media, aiming to deepen reflection on the issue of the need for recognition of the professional and humanised role of health caregivers in times of the COVID-19 pandemic.

Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study.

Objective:To describe Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method use for complementary feeding.Methods:Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method.Results:Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents.Conclusions:The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.

Labeling food allergens in the packaged food pyramid groups in Brazil: analysis of descriptions, ambiguities, and risks.

ABSTRACTObjective:The aim of this study was to evaluate allergenic labeling components of packaged foods for “What is the quality of food labels?” and “What is the group of Brazilian Food Pyramid that ‘May contain’ is predominant?.”Methods:The photographs of 916 products were obtained, of which 518 were analyzed. Data from each label were evaluated according to Brazilian Food Pyramid Groups (i.e., Cereals, Fruits, & Vegetables; Soybean & products; Milk & dairy products; Meat & eggs; Fats & oils; and Sugars & sweets). Ten items were analyzed in each label, namely, the presence of a list of ingredients, alert phrase for allergy sufferers, grouping of the alert phrase, phrase location, uppercase phrase, the phrase in bold, the color of alert phrase contrasting to the background, adequate font size, do not claim the absence for any allergen with the ingredients, and others factors that make it difficult to read. For the second question, a structured questionnaire was completed, and products were classified into two categories, namely, “Contain” and “May contain.”Results:The quality of the label was appropriate, and 69% of packaged foods had at least one allergen. The information “May contain” were higher in cow’s milk (Cereals and Meat & eggs), soy (Soybean & products), and egg protein (Cereals). Soybean & products were the highest insecurity group.Conclusions:Brazilian health professionals can count on good-quality labeling of packaged products. Consequently, they could promote patients’ and parents/caregivers’ education to consult the labels and manage the risks in processed foods about precautionary allergen labeling. Soybean & products were the most significant insecurity for food choices between Brazilian Pyramid Groups.

Cultural adaptation and validation of the Strategies to end seclusion restraint module of the QualityRights ToolKit.

to adapt to the Brazilian culture and validate the module "Strategies to end seclusion restraint" of the QualityRights toolkit of the World Health Organization on mental disorders to train health professionals in Brazil. it is a methodological study divided into three stages. The modules were translated from the original language (English) to the target language (Brazilian Portuguese) in the first stage. In the second, the translation was assessed by a committee of judges with seven experts. In the third stage, the assessment was conducted by mental health professionals (nurses, psychologists, and lawyers), in which seven mental health professionals participated. They assessed the material using the Suitability Assessment of Materials instrument. in the assessment conducted by the experts (n=7), 8 items assessed obtained 100% approval and the other 6 items obtained lower approvals, with a total approval of 92%. Regarding the assessment by health professionals (n=7), 2 items had a maximum approval of 100% and the other had the approval of 86% each, with a total approval of 88%. based on the results, it is considered that this module is adapted to the Brazilian culture and can be used to train Brazilian health professionals.

Adaptação cultural e validação do módulo Strategies to end seclusion restraint do ToolKit QualityRights

Objective to adapt to the Brazilian culture and validate the module “Strategies to end seclusion restraint” of the QualityRights toolkit of the World Health Organization on mental disorders to train health professionals in Brazil.Method it is a methodological study divided into three stages. The modules were translated from the original language (English) to the target language (Brazilian Portuguese) in the first stage. In the second, the translation was assessed by a committee of judges with seven experts. In the third stage, the assessment was conducted by mental health professionals (nurses, psychologists, and lawyers), in which seven mental health professionals participated. They assessed the material using the Suitability Assessment of Materials instrument.Resultsin the assessment conducted by the experts (n=7), 8 items assessed obtained 100% approval and the other 6 items obtained lower approvals, with a total approval of 92%. Regarding the assessment by health professionals (n=7), 2 items had a maximum approval of 100% and the other had the approval of 86% each, with a total approval of 88%.Conclusionbased on the results, it is considered that this module is adapted to the Brazilian culture and can be used to train Brazilian health professionals.