Qualitative Study In Brazil Research Articles

PCR30 The Burden of Familial Chylomicronemia Syndrome (FCS) in Brazilian Patients – A Pilot Qualitative Study

FCS in Brazil is characterized by low clinical awareness that negatively affects the patient journey and experience, often resulting in inadequate care. Research addressing the FCS patient burden in Brazil could provide insights to refine healthcare services and improve outcomes. This is the first qualitative study in Brazil aimed to understand the burden of FCS in patients.

Mothers’ Understanding of Brain Development in Early Childhood: A Qualitative Study in Brazil

To analyze mothers’ understanding of child brain development and their stimulus practices with children in the first months of life. Qualitative research, with 18 Brazilian mothers, over 18 years of age, used semi-structured interviews to identify their perspectives on important healthcare outcomes, based on reflexive thematic analysis. Mother’s accounts displayed little understanding of child brain development, focusing on the development of neuropsychomotor skills. There was relative uncertainty about the daily care practices that would provide appropriate child stimuli, through which to provide promotion and protection of child development. Maternal knowledge about child brain development indicates a need to strengthen parenting practices in early childhood. Expanding this knowledge and practices can contribute to parental caregivers being immediate providers of child development, to detect vulnerabilities and early difficulties. In addition, this approach would promote involvement in daily care and increase shared responsibility in the construction of strengthened executive functions for good child development.

The experience of receiving a diagnosis of depression in adolescence: A pilot qualitative study in Brazil.

Receiving a diagnosis of depression can have an important impact on the lives of adolescents. However, there is limited information about how youth tackle, attribute meaning to and understand mental health diagnoses. The aim of this study was to explore adolescents' initial reactions after receiving a clinical diagnosis of Major Depressive Disorder in the context of a neurobiological study of depression in Brazil. Using a qualitative design, eight Brazilian adolescents were interviewed twice: immediately after a psychiatric assessment and neuroimaging study, in which they were given a diagnosis of depression, and in a follow-up visit 2 weeks later. Interviews were designed to explore the subjective experience of receiving the diagnosis and the impacts of depression on adolescents' lives. Framework Analysis was used to analyze the accounts. Diagnosis was perceived as a reification of an abnormal status, highlighting the role of stigma and the process of disclosing the diagnosis to others. Adolescents reported the multiple sensemaking processes that occurred when they received a diagnosis of depression, and most struggled with the idea that negative emotions would equate their experience with a disorder. The results show that future efforts could enhance clinical assessment processes with adolescents by exploring adolescents' reactions to diagnosis, as well as the support networks available to them, resulting in increased help-seeking behaviors, and diminished social and personal stigma.

The Culture and Personal Disposal Practices of University Students: A Qualitative Study in Brazil and Germany

This study aimed to investigate the relationship between cultural components and municipal solid waste (MSW) disposal individual practices in the context of Brazilian and German university students. To achieve this goal, we chose to conduct qualitative research with ethnographic inspiration, exploratory and descriptive nature. For one year, the authors collected data through participant and non-participant observations, interviews and photographs from both countries. The results showed that waste disposal is a constant concern in Germany. Waste separation for recycling is cultural and is the primary waste disposal practice in the country. In Brazil, the primary practice is to dispose of all waste in just one bin. Several elements of the cultural components are involved in these practices, revealing a significant sustainable cultural difference between the two countries. One of the limitations of the study is Brazil itself. Brazil is a continental and multi-cultural country. The results present a perceived country general view; but maybe in other cities inside Brazil, some differences could be present. As an empirical contribution, the study presents a lack of public policy and gives suggestions to improve the structure (material culture) and communication (and language) of the practices through actions. These actions can be the implementation of the selective collection in the city, improved enforcement of laws or even new public policies aimed at waste management. The originality of the article consists in investigating and comparing the disposal practices of MSW of Brazilian and German students in the light of culture. This study innovates bringing an empirical analysis of cultural components little studied.

Detection of risk for depression among adolescents in diverse global settings: protocol for the IDEA qualitative study in Brazil, Nepal, Nigeria and the UK

IntroductionGlobally, depression is a leading cause of disability among adolescents, and suicide rates are increasing among youth. Treatment alone is insufficient to address the issue. Early identification and prevention efforts...

Mental health and challenges of transgender women: A qualitative study in Brazil and India

Background: Transgender women from low- and middle-income countries (LMICs) are understudied, their coping strategies and struggles underrecognised.Aims: This study aimed to explore the lived experiences of transgender women from two major cities located in Brazil and India, LMICs with high rates of transphobia and gender-based violence.Methods: We conducted a mixed-methods, exploratory study, including focus group discussions (FGDs) and brief survey interviews with 23 transgender women from Hyderabad, India and 12 transgender women from Rio de Janeiro, Brazil. Herein we present the combined (qualitative and quantitative) results related to discrimination, stigma, violence, and suicidality in transgender women’s lives.Results: Three major themes emerged from FGDs: stigma and discrimination; violence, and suicidality. Lack of education and working opportunities influence high levels of poverty and engagement in survival sex work by transgender women in both cities. Study participants live in large cities with more than 6 million inhabitants, but transgender women reported chronic social isolation. Participants disclosed frequent suicide ideation and suicide attempts. Brief surveys corroborate FGD findings, identifying high prevalence of discrimination, intimate partner violence, suicidality and low social support.Discussion: Multiple layers of stigma, discrimination, violence and social isolation affect transgender women’s quality of life in Hyderabad and Rio de Janeiro. Strategies sensitive to gender and culture should be implemented to tackle entrenched prejudice and social exclusion reported by transgender women. Additional social support strategies, better access to education and employment opportunities are also urgently needed. Improving the availability of evidence-based mental health interventions addressing the high prevalence of suicidality among transgender women from Hyderabad, India and Rio de Janeiro, Brazil should be prioritized.

Consumers' opinions on warning labels on food packages: A qualitative study in Brazil.

This study aimed to assess consumers’ uses of and opinions on the current Brazilian food label and their reaction to the introduction of a front-of-package warning label. We conducted 12 focus groups among a diverse sample of adult consumers, to broadly assess: (1) uses of and perceptions about the current food label, and (2) opinions about implementing a front-of-package warning label to guide food purchases. Data was analyzed with a triangulation of researchers using an exploratory content analysis, which allowed codes to emerge from the data. The frequency of codes across focus groups was compared by gender and socioeconomic status to explore differences by these sociodemographic factors. Codes were divided into six main themes: (1) “Reasons for using food labels”; (2) “Barriers to using food labels”; (3) “Requirements for a new label”; (4) “Perceived influence on consumption behaviors”; (5) “Perceived influence on child behaviors”; and (6) “Perceptions of the food manufacturers using of warning labels”. Participants used food labels to check nutrient content and ingredient information but the format of these labels and the technicality of the content displayed often made the information inaccessible, particularly for those with low socioeconomic status. Most participants were supportive of the display of front-of-package warning labels on products and considered them useful to inform purchases. Women believed that they and their children would reduce the consumption of foods with front-of-package warning labels, while men reported more polarity in their intentions. For men and their children, front-of-package warning labels would result in either stopping food intake entirely or continued consumption without changes to the amount. The study results highlight the potential of front-of-package warning labels to support healthier behaviors in both consumers and their children.

Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil

BackgroundEvidence shows that women who have sex with women (WSW) face disparities in access to health care when compared to heterosexual women in several countries. AimTo investigate the experiences WSW have after disclosure of sexual orientation during gynecological care in Brazil. MethodsWe performed a qualitative study using content analysis. We recorded and transcribed interviews with 34 WSW from the 5 regions in Brazil. Data were analyzed using descriptive content analysis. OutcomesThe main categories of analysis were decision-making process to disclose and attitude of gynecologists after disclosure. ResultsWSW disclosed their sexual orientation in an un-favorable environment. Gynecologists rarely asked about patients’ sexual orientation and used a script for hetero-normative anamnesis. The reactions of gynecologists were discriminatory, resulting in abbreviated consultations and un-comfortable gynecological exams. They missed a window of opportunity for prevention, diagnosis, and treatment of various diseases. The experiences Brazilian WSW had during gynecological care demonstrated the dominant hetero-normativity in the health care scenario. The attitudes of the gynecologists precarized the existence of WSW in health service. Clinical ImplicationsThis study suggests that gynecologists missed an opportunity to use WSW's sexual orientation disclosure to offer specific care to them. Strengths & LimitationsThis is the first qualitative study about WSW’s experiences during gynecological care in Brazil. Future studies should be developed from a wider sampling, especially among lower-class WSW. ConclusionThe results point out the need for a change in medical training and guidelines to assist WSW in the country.Rufino AC, Madeiro A, Trinidad AS, et al. Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil. J Sex Med 2018;15:966–973.

Obstetrician's risk perception on the prescription of magnesium sulfate in severe preeclampsia and eclampsia: A qualitative study in Brazil.

IntroductionMagnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been identified in the use of MgSO4, especially in low and middle-income settings.ObjectiveTo describe the obstetrician’s perception on possible reasons for underutilizing magnesium sulfate to treat preeclampsia/eclampsia.MethodA qualitative clinical study, based on phenomenological reference by semi-structured interviews and open-ended discussions with obstetricians of the public healthcare system in primary care units (PCU) and referral maternity hospitals (RMH), in a southeastern Brazilian city.ResultsFear of drug toxicity was the major cause for not prescribing the medication in PCU. Fear was justified by insufficient technical, structural and organizational resources of healthcare facilities and by a shortage of physicians properly trained for adequate drug use.ConclusionFear of toxicity of magnesium sulfate was the main barrier towards timely and proper drug use. Periodic skill development and training of obstetricians, along with integration of the medical team in the work environment may contribute to decrease fear, ensuring safety of drug prescription and thus possibly reducing adverse outcomes related to PE.

Societal impact of dengue outbreaks: Stakeholder perceptions and related implications. A qualitative study in Brazil, 2015.

BackgroundThe growing burden of dengue in many countries worldwide and the difficulty of preventing outbreaks have increased the urgency to identify alternative public health management strategies and effective approaches to control and prevent dengue outbreaks. The objectives of this study were to understand the impact of dengue outbreak on different stakeholders in Brazil, to explore their perceptions of approaches used by governmental authorities to control and prevent dengue outbreaks and to define the challenges and implications of preventing future outbreaks.MethodsIn 2015, a qualitative study was conducted in two urban states in Brazil: São Paulo, which was experiencing an outbreak in 2015, and Rio de Janeiro, which experienced outbreaks in 2011 and 2012. Face-to-face interviews using a semi-structured questionnaire were conducted with nine different categories of stakeholders: health workers (physicians, nurses), hospital administrators, municipal government representatives, community members and leaders, school administrators, business leaders and vector control managers. Interviews were focused on the following areas: impact of the dengue outbreak, perceptions of control measures implemented by governmental authorities during outbreaks and challenges in preventing future dengue outbreaks.ResultsA total of 40 stakeholders were included in the study. Health workers and community members reported longer waiting times at hospitals due to the increased number of patients receiving care for dengue-related symptoms. Health workers and hospital administrators reported that there were no major interruptions in access to care. Overall financial impact of dengue outbreaks on households was greatest for low-income families. Despite prevention and control campaigns implemented between outbreak periods, various stakeholders reported that dengue prevention and control efforts performed by municipal authorities remained insufficient, suggesting that efforts should be reinforced and better coordinated by governmental authorities, particularly during outbreak periods.ConclusionThe study shows that a dengue outbreak has a multisectorial impact in the medical, societal, economic and political sectors. The study provides useful insights and knowledge in different stakeholder populations that could guide local authorities and government officials in planning, designing and initiating public health programs. Research focused on a better understanding of how communities and political authorities respond to dengue outbreaks is a necessary component for designing and implementing plans to decrease the incidence and impact of dengue outbreaks in Brazil.

Barriers and Benefits in Telemedicine Arising Between a High-Technology Hospital Service Provider and Remote Public Healthcare Units: A Qualitative Study in Brazil.

In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants. An individual, semistructured recorded interview was conducted with 28 physicians (17 HT; 11 RU) encompassing telemedicine resources and interaction among HT and RU physicians. Data analysis was performed by Discourse of Collective Subject. We identified the following barriers in the telemedicine service: (1) lack of experience in the use of technology or the quality of the internet signal; (2) the multiplicity of different telemedicine platforms; (3) the quality of the image sent to the HT hospital; (4) the misunderstanding that telemedicine is a time-consuming technology instead of a resource that may help to save lives; (5) not feeling comfortable exposing doubts to other HT colleagues; (6) problems in the management of telemedicine use in the RUs; and (7) political and legal issues. However, important benefits in telemedicine service were also described. The structural barriers should be the target of hospital managers. Development of standard remote care protocols may increase the use of telemedicine and create new work routines. Given the relationship difficulties among the RU and HT doctors during telemedicine consultations, other meetings should be organized to allow more interpersonal interactions. These meetings may also have the goal of sharing outcome indicators of their joint activity in telemedicine to stimulate and make them aware of the benefits of their interaction.

Subjective aspects of people with chronic ulcers: a qualitative study in Brazil and Portugal

Subjective aspects of people with chronic ulcers: a qualitative study in Brazil and Portugal

Weight regain among women after metabolic and bariatric surgery: a qualitative study in Brazil.

Due to the increased number of bariatric surgeries over the years, aspects contributing or hindering the achievement of outcomes, among them weight regain, have acquired increased significance. Psychological factors directly influence on this unwanted situation, but there are few studies and controversies about the degree of participation of these factors. We propose a qualitative investigation to analyze the meanings of weight regain after surgery among women and how these factors influence this outcome. This study uses the clinical-qualitative method, by means of a semi-structured interview with open questions in an intentional sample, closed by saturation, with eight women who underwent surgery at the Bariatric Surgery Outpatient Clinic of Hospital das Clínicas, Universidade Estadual de Campinas (UNICAMP), in the state of São Paulo, Brazil. A feeling of defeat and failure emerges with weight regain, which contributes to social isolation; there is no regret, but gratitude for the surgery; among patients, there is a sense of feeling rejected greater than a rejection that actually exists. We found out the need for further qualitative studies that help the health team to better understand the dynamic psychological factors involved in the meaning of weight regain after bariatric surgery among women, in order to adopt appropriate conducts to deal with this problem.

Palliative Care Research in Latin America and the Caribbean: From the Beginning to the Declaration of Venice and Beyond

Research in palliative care has increased significantly in the last decade, while the vast majority of the global disease burden occurs in developing countries. To explore the palliative care research activity in Latin America and the Caribbean (LAC) and its visibility in the international palliative care literature, with a special focus on research studies. A bibliometric analysis was conducted in MEDLINE(®), Embase(®), PsycINFO(®), and CINAHL(®). Inclusion criteria were: (1) articles published in peer-reviewed scientific journals; (2) main subject was palliative care; (3) research study; (4) the first author or coauthors was based in LAC; and/or (5) the data collected derived from LAC. One hundred six articles from 10 countries were identified in the literature research. The first publication dates from 1989 and was a qualitative study in Brazil. This study shows a modest contribution of publications from LAC. However, the volume of publications within the region is distributed unequally, reflecting the heterogeneity of the region: Brazil published more than half of the articles, while 35 countries have no publications. Most of the studies were quantitative research, predominantly cross-sectional studies. Qualitative studies often used interviews. Health care service was the most researched issue. Seventy percent of studies were carried out in institutions. Palliative care research should have a place in LAC. The development of a regional research agenda tailored to the needs and features of the region considering the health care structure and local resources available is indispensable.

ABS79: Patterns of primary care for children with asthma: An exploratory, qualitative study in Brazil

Asthma is the most common chronic lung disease diagnosed in children in Brazil and represents a personal and social burden for subjects and their families and direct and indirect costs related to management of the disease. Although there are nationally-based initiatives to implement standards of care, it is supposed that a wide range of practices would be observed, especially when comparing family medicine practitioners and primary care pediatricians. To explore and compare the process of care received by children with asthma served by primary care physicians (family medicine practitioners and primary care pediatricians) in Brazil. Subject and methods: A qualitative approach was used to study responses for cases assigned to family medicine practitioners and pediatricians through a mailed questionnaire with multiple-choice and open-ended questions. Three provider types were identified: Family medicine specialists, Family medicine non-specialists and primary-care pediatricians, all working in the Brazilian public, Unified Health System. Process of care measures reflecting aspects of care recommended in national guidelines were developed and used to analyze patterns of care across provider types, controlling for case-mix and other covariates. Management of asthma in children had a wide variation in terms of diagnosis, classification, pharmacological treatment in acute and maintenance care, educational and preventive measures and follow-up practices, inside each group of providers and through the distinct groups. Differences were significantly higher among Family Medicine specialists and non-specialists. Level of agreement of practitioners with guidelines and standards of care were low and dependant of age, years of experience in primary care, specialization and complexity of case. Use of evidence-based, services-oriented guidelines for caring of children with asthma is not disseminated. Continuing professional development in childhood asthma in Brazil is an issue to be concerned with, especially with the increment of access and coverage of public primary care services. Conflict of interest and funding None.

Intergenerational interaction in health promotion: a qualitative study in Brazil.

In 1994 a pilot intergenerational project was started in the city of Taguatinga, Brazil, to promote the well-being of both elderly and adolescent populations using reminiscence processes as a means of interaction. The purpose of the study is to evaluate the project from the participants' viewpoint and to improve the contribution of those age groups in building up social capital. From November 1999 to April 2000 a qualitative study using focus groups technique was conducted. Using a discussion guide, 9 groups of students, ranging in age from 13 to 19 years old, and 3 groups of elderly aged 60 years and over were interviewed to collect data regarding their interaction before and after an intergenerational program. The main findings suggested a change in attitude of young people toward old age and elderly people. Participating elderly people reported improvement in their health status. For both age groups the findings suggested a better understanding between generations. It seems that reminiscence intergenerational activity contributes to building up mutual trust and reciprocity. These results seem to indicate this is an alternative for investing in social capital and improving participants' well-being. However, further work is needed to support these findings.