Fatores de risco e complicações em hipertensos/diabéticos de uma regional sanitária do nordeste brasileiro

Objetivou-se com este estudo identificar os fatores de risco e a complicações associadas em usuários com hipertensão/diabetes, cadastrados no HIPERDIA da Secretaria Executiva Regional VI em Fortaleza, CE. O estudo documental analítico abordou 2.691 pessoas. Do total, 73,6% eram mulheres; 44,6% tinham 60-79 anos, com média de 60,8 anos; 87,4% eram brancos, amarelos ou pardos; 63,7% tinham até oito anos de estudo; 79,7% não eram fumantes; 56,6% sedentários; 59,6% apresentavam sobrepeso/obesidade; 48,4% possuíam antecedente familiar de doença cardiovascular. Verificou-se associação entre sedentarismo e sobrepeso/obesidade com diabéticos e diabéticos hipertensos; antecedente familiar de doença cardiovascular com os hipertensos e diabéticos hipertensos; acidente vascular encefálico, doença arterial coronariana e insuficiência renal crônica com hipertensos e diabéticos hipertensos; infarto e acidente vascular encefálico com diabéticos. O antecedente familiar cardiovascular associou-se com doença arterial coronariana e infarto. Evidenciou-se a presença relevante de fatores de risco e complicações, destacando a necessidade da educação em saúde com os usuários

Menopause Is a Natural Stage of Aging: A Qualitative Study

Abstract Background Menopause is a biopsychosocial phenomenon encompassing the transition in a woman’s life from being fertile to infertile. Although menopause may result in extremely unpleasant physical symptoms there is evidence of a low rate of reported menopausal symptoms amongst women in Asian cultures. Women’s experiences, views, and responses to menopause which influences women’s daily life and well-being, may vary between different societies and cultures. This study aimed to explore and describe menopausal experiences among women in Sri Lanka. Methods A qualitative exploratory research was conducted among postmenopausal women of 46-55 years of age in the western province of Sri Lanka. Individual interviews with a purposive sample of 20 women were conducted, and data analysis was done using manifest and latent content analysis. Results The results consist of an overall theme, “Menopause is a natural stage of aging” and three categories “Entering a new stage”, “Managing menopause” and “Not the end of life” which emerged from 34 codes. The overall theme highlights that changes in menopause were experienced as a natural change in life, with health problems that are normal for this change and handled with different self-care practices. The category “Entering a new stage” describes the women becoming aware of menopause and its bodily changes. The category “Managing menopause” describes women’s experiences of being able to find their own remedies to ease the menopausal symptoms and by engaging in religious activities and focusing on interaction with people. The category, “Not the end of life” describes women's views of themselves as still valuable because menopause was experienced as a natural part of their lives. Conclusion Women in Sri Lanka managed menopausal problem mainly on their own as they viewed the menopause as a natural stage of aging risking unnecessary suffering and failure to detect preventable complications. Enabling support groups for menopausal women and improving on their health-seeking behaviour by encouraging them to take part in screening for cervical and breast cancer would improve their condition. Further information on additional hormone therapy with a, subsequent follow-up and evaluation by community health nurses and/or midwives, would facilitate Sri Lankan women's transition to menopause.</jats:p

Menopause Is a Natural Stage of Aging: A Qualitative Study

Abstract Background Menopause is a biopsychosocial phenomenon encompassing the transition in a woman’s life from being fertile to infertile. Although menopause may result in extremely unpleasant physical symptoms there is evidence of a low rate of reported menopausal symptoms amongst women in Asian cultures. Women’s experiences, views, and responses to menopause which influences women’s daily life and well-being, may vary between different societies and cultures. This study aimed to explore and describe menopausal experiences among women in Sri Lanka. Methods A qualitative exploratory research was conducted among postmenopausal women of 46-55 years of age in the western province of Sri Lanka. Individual interviews with a purposive sample of 20 women were conducted, and data analysis was done using manifest and latent content analysis. Results The results consist of an overall theme, “Menopause is a natural stage of aging” and three categories “Entering a new stage”, “Managing menopause” and “Not the end of life” which emerged from 34 codes. The overall theme highlights that changes in menopause were experienced as a natural change in life, with health problems that are normal for this change and handled with different self-care practices. The category “Entering a new stage” describes the women becoming aware of menopause and its bodily changes. The category “Managing menopause” describes women’s experiences of being able to find their own remedies to ease the menopausal symptoms and by engaging in religious activities and focusing on interaction with people. The category, “Not the end of life” describes women's views of themselves as still valuable because menopause was experienced as a natural part of their lives. Conclusion Women in Sri Lanka managed menopausal problem mainly on their own as they viewed the menopause as a natural stage of aging risking unnecessary suffering and failure to detect preventable complications. Enabling support groups for menopausal women and improving on their health-seeking behaviour by encouraging them to take part in screening for cervical and breast cancer would improve their condition. Further information on additional hormone therapy with a, subsequent follow-up and evaluation by community health nurses and/or midwives, would facilitate Sri Lankan women's transition to menopause.</jats:p

Women's perceptions and responses towards abnormal vaginal discharge: Focus Group Discussions in a socially marginalized community

Objective: Vulvo-vaginal discharge, which is a common gynaecological complaint, can be a normal phys- iological discharge or a symptom of an underlying reproductive tract infection, genital tract neoplasm, or other reproductive tract disorder. It is pertinent to differentiate physiological discharge from a pathological vulvo-vaginal discharge in order to prevent complications of untreated reproductive tract infections. Women are not seeking health advices for most of their gynaecological health issues and have different cultural practices to manage them. This study was conducted to explore the different cultural practices associated with vulvo-vaginal discharge among females aged 18–49 years living in an estate community in Colombo district, Sri Lanka. Methods: This descriptive qualitative study used three Focus Group Discussions (FGDs) with a total number of 20 women. Transcribed verbatim data were analyzed using qualitative content analysis. Results: Majority of the participants were Indian Tamils (n = 17, 85%) and Hindu (n = 15, 75%). Most (65%) of women were employed in the estate labour and educated up to grade 11 (n = 13). The major themes identified in the present study were difficulty in differentiating normal from abnormal vaginal discharge, lack of knowledge on causative factors, cultural influences and beliefs, unstable/limited source of income, fear of disclosing, and lack of support system. Many participants explained that they have difficulty in accessing health care as they are busy with their employment, household work, fear of internal examination, and fear of being admitted to the hospital ward. The common practice was to use home remedies such as polpala herbal drink (Balipoovu, Aerva lanata) or Neeramulliya (Asteracantha longifolia Linn) herbal drink, king coconut, Sauw (sago) Kanji, Uluhal (Fenugreek), and Aloe vera juice prior consulting medical advice for abnormal vaginal discharge. Conclusions: The findings of this study revealed the need of support for women in estate sector for their repro- ductive and sexual health matters. There is a high need of public health care worker’s guidance and counselling to overcome barriers for health care utilization in this community. </jats:sec

How do urban slum women manage excessive vaginal discharge? A community based cross sectional study

Abstract Background: Early detection of gnaecological morbidities is an important factor in treating and managing the underline disease. Abnormal vaginal discharge, which is a recurring problem for most of the women at reproductive age is a good predictor for many gynaeclogical morbidities. Many women constantly neglect abnormal vaginal discharge because of the prevailing “culture of silence”. Women who live in urban slum are vulnerable for many unhealthy practices and lifestyles and having a high prevalence of reproductive tract infection especially sexually transmitted infections. Hence, this study was aimed to describe urban slum women’ understanding, attitudes and related practices for abnormal vaginal discharge. Methods: This community based cross sectional study was conducted among 550 women living in urban slum in the Colombo Municipal Council area, Colombo District, Sri Lanka during September- March 2016. A multistage cluster sampling technique was used. A validated, pretested Interviewer Administered Questionnaire was used to collect information from females. Data were analysed using descriptive and relevant inferential statistics (Chi square test and one-way analysis of variance (ANOVA). Results: The majority of women (89.5%) was unemployed and were married (92%). The mean age of the women was 32.51 (SD±7.94) years. Mean knowledge score was 29.18 (SD± 8.68). Most of the women (97.1%) had inadequate level of knowledge (&lt;50%). A significant association was observed between the knowledge score levels with the participants’ educational level (p=0.00). Major areas of knowledge deficit include causes for pathological vaginal discharge and reproductive tract infections. Majority (95.9%) agreed that abnormal vaginal discharge should be taken seriously but from the women who accepted (78.2%) that vaginal discharge has ever been a concern to them, only 59% had consulted a general practitioner. There was a significant relationship with having accompanying symptoms such as burning sensation and lower abdominal pain and consulting a general practitioner (p&lt;0.05). Conclusion: The findings of the study imply the importance of health education to improve the health seeking behaviours. The culture specific health education intervention measures need to be targeted in order to improve their knowledge, attitudes and practices towards vaginal discharge as well as disease prevention and health promotion.</jats:p

The prevalence and related factors of pre‐diabetes and diabetes among overweight and obese children in Urban schools

Objective: This study aimed to determine the prevalence of pre‐diabetes and diabetes among overweight and obese children in urban schools and factors associated with them, in Batticaloa District, Sri Lanka. Methods: A school based cross‐sectional descriptive study was conducted to collect data on socio-demographic information, eating habits and physical activities, using a validated, pre-tested questionnaire. In addition, anthropometric measurements and glycosylated haemoglobin (HbA1c) test were performed. Multivariate logistic regression analyze was performed to identify the factors associated with glycemic status by using SPSS v23. Results: Out of the 269 children recruited, 59% were obese. Prevalence of pre‐diabetes (HbA1c 5.7%–6.4%) and diabetes (HbA1c ≥ 6.5%) were 20.1% (95% CI 15.5%–25.4%) and 3.3% (95% CI 1.5%–6.3%) respectively. Multivariate regression shows that having a BMI of ≥ 27.5Kg/m2 (AOR=2.69), male gender (AOR=2.71) and ethnicity (AOR = 2.58) were found to be significant factors for higher HbA1c (≥5.7%). Conclusions: Prevalence of prediabetes and diabetes among overweight and obese school children was high and mainly associated with body weight which is a modifiable risk factor. Lifestyle modifications focusing on weight reduction among overweight and obese school children especially boys, need to be carried out

The prevalence and related factors of pre‐diabetes and diabetes among overweight and obese children in Urban schools

Objective: This study aimed to determine the prevalence of pre‐diabetes and diabetes among overweight and obese children in urban schools and factors associated with them, in Batticaloa District, Sri Lanka.&#x0D; Methods: A school based cross‐sectional descriptive study was conducted to collect data on socio-demographic information, eating habits and physical activities, using a validated, pre-tested questionnaire. In addition, anthropometric measurements and glycosylated haemoglobin (HbA1c) test were performed. Multivariate logistic regression analyze was performed to identify the factors associated with glycemic status by using SPSS v23.&#x0D; Results: Out of the 269 children recruited, 59% were obese. Prevalence of pre‐diabetes (HbA1c 5.7%–6.4%) and diabetes (HbA1c ≥ 6.5%) were 20.1% (95% CI 15.5%–25.4%) and 3.3% (95% CI 1.5%–6.3%) respectively. Multivariate regression shows that having a BMI of ≥ 27.5Kg/m2 (AOR=2.69), male gender (AOR=2.71) and ethnicity (AOR = 2.58) were found to be significant factors for higher HbA1c (≥5.7%).&#x0D; Conclusions: Prevalence of prediabetes and diabetes among overweight and obese school children was high and mainly associated with body weight which is a modifiable risk factor. Lifestyle modifications focusing on weight reduction among overweight and obese school children especially boys, need to be carried out.</jats:p