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Epidemiology of obstetric violence: a narrative review of the Brazilian context. 产科暴力流行病学:对巴西情况的叙述性回顾。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-09-13 DOI: 10.1590/1413-81232024299.12222023
Tatiana Henriques Leite, Emanuele Souza Marques, Rachel Geber Corrêa, Maria do Carmo Leal, Bheatriz da Costa Diniz Olegário, Rafaelle Mendes da Costa, Marilia Arndt Mesenburg

The aim of this review is to present the state of the art regarding obstetric violence in Brazil. The most commonly used terms are "obstetric violence," "disrespect and abuse," and "mistreatment". Concerning measurement, the most widely used instrument is based on the definition of "mistreatment," still in its early stages of evaluation and lacking adaptation to Brazil. The prevalence of obstetric violence varies widely in national studies due to methodological factors and the type of postpartum women considered. Regarding risk factors, adolescent or women over 35, non-white, with low education levels, users of the public health system (SUS), those who had vaginal birth or abortion, are at higher risk. Hierarchical relationships between the healthcare team and the family are also relevant, as well as inadequate hospital structures, bed shortages, and insufficient healthcare professionals, which contribute to obstetric violence. The consequences of this violence include an increased risk of postpartum depression and PTSD, reduced likelihood of attending postpartum and childcare consultations, and difficulties in exclusive breastfeeding. Interventions to mitigate obstetric violence should consider women's empowerment, healthcare professionals' training, monitoring obstetric violence, and legal support.

本综述旨在介绍巴西产科暴力的最新情况。最常用的术语是 "产科暴力"、"不尊重和虐待 "以及 "虐待"。关于测量,最广泛使用的工具是基于 "虐待 "的定义,但仍处于早期评估阶段,缺乏对巴西的适应性。由于方法因素和所考虑的产后妇女类型不同,各国研究中产科暴力的发生率差异很大。关于风险因素,青少年或 35 岁以上的妇女、非白人、受教育程度低、使用公共卫生系统(SUS)、经阴道分娩或流产的妇女风险较高。医护团队与家庭之间的等级关系,以及医院结构不完善、床位短缺、医护人员不足等因素也是产科暴力的诱因。产科暴力的后果包括产后抑郁和创伤后应激障碍的风险增加、产后就诊和育儿就诊的可能性降低以及纯母乳喂养困难。减轻产科暴力的干预措施应考虑赋予妇女权力、培训医疗保健专业人员、监测产科暴力和提供法律支持。
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引用次数: 0
Effects of age, period, and cohort on mortality by prostate cancer among men in the state of Acre, in the Brazilian Western Amazon. 年龄、时期和队列对巴西西亚马逊阿克里州男性前列腺癌死亡率的影响。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-09-03 DOI: 10.1590/1413-81232024299.14782022
Thainá Souza Ribeiro, Taynãna César Simões, Ilce Ferreira da Silva, Rosalina Jorge Koifman, Maria Fernanda de Sousa Oliveira Borges, Simone Perufo Opitz

The present study aimed to analyze the effects of age, time period, and birth cohort on the temporal evolution of mortality rates due to prostate cancer in men from the state of Acre, Brazil, in the period of 1990 to 2019. This is an ecological study in which the temporal trend was evaluated by the joinpoint method, estimating the annual percentage variations of the mortality rates. The age-period-birth cohort effects were calculated by using the Poisson Regression method, using estimation functions. The mortality rates showed an increase of 2.20% (95%CI: 1.00-3.33) in the period studied, tended to increase with age. A relative risk (RR) of 0.67 (95%CI: 0.59-0.76) was observed between 2005 and 2009, 0.76 (95%CI: 0.67-0.87) from 2005 on, and 1.44 (95%CI: 1.25-1.68) from 2015 on. The cohorts from 1910 to 1924 presented a risk reduction (RR < 1), when compared to the reference cohort (1935). Regarding the time period, the creation of public policies and the establishment of guidelines are suggested as factors which may have contributed to more access to diagnosis, in consonance with the cohort effect. These findings can contribute to a better understanding of the epidemiological scenario of prostate cancer in regions that are more vulnerable in terms of socioeconomic conditions.

本研究旨在分析 1990 年至 2019 年期间年龄、时间段和出生队列对巴西阿克里州男性前列腺癌死亡率时间演变的影响。这是一项生态学研究,采用连接点法评估时间趋势,估计死亡率的年度百分比变化。使用泊松回归法和估算函数计算了年龄-时期-出生队列效应。在研究期间,死亡率上升了 2.20%(95%CI:1.00-3.33),并有随年龄增长而上升的趋势。2005 年至 2009 年的相对风险为 0.67(95%CI:0.59-0.76),2005 年以后为 0.76(95%CI:0.67-0.87),2015 年以后为 1.44(95%CI:1.25-1.68)。与参考队列(1935 年)相比,1910 年至 1924 年的队列风险降低(RR < 1)。就时间段而言,公共政策的制定和指南的确立可能有助于增加诊断机会,这与队列效应是一致的。这些发现有助于更好地了解在社会经济条件方面较为脆弱的地区前列腺癌的流行情况。
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引用次数: 0
[Prevalence of the use of integrative and complementary practices and chronic diseases: 2019 National Health Survey]. [综合和补充疗法的使用率与慢性疾病:2019 年全国健康调查]。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-09-15 DOI: 10.1590/1413-81232024299.20442022
Mário Círio Nogueira, Ana Carolina Moreira Bicalho, Ana Flávia Côrrea Magalhães, Julia Barroso Marques Martins, Marcella Barroso Marques Martins

The study sought to investigate the association between having a chronic disease or condition and the prevalence of having recourse to Integrative and Complementary Practices (ICP) among the Brazilian adult population. Chronic diseases are a serious public health issue and there are limitations of Western medicine to offer effective answers. Thus, the demand for ICP has increased as they constitute a humanized treatment option, with low cost and ease of acquisition. A cross-sectional population-based study was carried out using data from the 2019 National Health Survey. The prevalence of ICP use was estimated by categories of the other variables (presence or absence of chronic conditions) and prevalence ratios (PR) were adjusted for sociodemographic variables. The prevalence of the use of a given ICP, in the last 12 months, by the adult Brazilian population (18 years of age and over) was 5.5% (95%CI: 5.2%-5.8%), and adults with a chronic condition had a higher prevalence of use (PR: 2.11; 95%CI: 1.89-2.36), even after adjusting for sociodemographic characteristics. Stroke, asthma, arthritis, work-related musculoskeletal disorders, depression and other mental illnesses, chronic obstructive pulmonary disease, cancer and heart disease such as hypertension were associated with a higher prevalence of ICP use.

这项研究旨在调查巴西成年人群中患有慢性疾病或病症与采用综合互补疗法(ICP)之间的关系。慢性疾病是一个严重的公共卫生问题,而西医在提供有效答案方面存在局限性。因此,对中西医结合疗法的需求不断增加,因为它是一种人性化的治疗选择,成本低,易于获得。我们利用 2019 年全国健康调查的数据开展了一项基于人群的横断面研究。根据其他变量的类别(有无慢性病)估算了ICP的使用流行率,并根据社会人口变量调整了流行率(PR)。巴西成年人口(18 岁及以上)在过去 12 个月中使用特定 ICP 的流行率为 5.5%(95%CI:5.2%-5.8%),即使调整了社会人口学特征,患有慢性疾病的成年人使用 ICP 的流行率更高(流行率:2.11;95%CI:1.89-2.36)。中风、哮喘、关节炎、与工作有关的肌肉骨骼疾病、抑郁症和其他精神疾病、慢性阻塞性肺病、癌症和心脏病(如高血压)与ICP使用率较高有关。
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引用次数: 0
Intersection between access difficulties and obstetric violence in abortion itineraries. 堕胎行程中的获取困难与产科暴力之间的交集。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-10-18 DOI: 10.1590/1413-81232024299.04552023
Jamile Guerra Fonseca, Edméia de Almeida Cardoso Coelho, Larissa Silva de Abreu Rodrigues, Joise Magarão Queiroz Silva, Railene Pires Evangelista, Aline Célia Caribé de Araújo Melo

In Brazil, several limitations are imposed upon the access of women undergoing abortion to the healthcare network, primarily caused by the influence of moral and religious values and gender iniquities. In this light, the present study aimed to analyze the experience of women who had an abortion regarding the care provided by healthcare services as part of the abortion itinerary. This is a qualitative study, carried out with 18 women in three cities - one small city, one mid-sized, and one big - in the state of Bahia. Data were produced by face-to-face or online interviews. The empirical material was analyzed using the discourse analysis technique. The results show, in the three municipalities, abortion itineraries under social and gender iniquities, with greater access difficulties for low-income women. Better financial conditions allow access to clandestine private clinics but without guaranteeing humanized care. In the three municipalities, economically disadvantaged women self-induced abortions and delayed seeking services, having faced embarrassing and prejudicial professional attitudes. The results point to the urgency of implementing public policies in which reproductive rights are as effective as human rights.

在巴西,接受人工流产的妇女在利用保健网络方面受到一些限制,这主要是受道德和宗教价值观以及性别不公正的影响。有鉴于此,本研究旨在分析堕胎妇女在堕胎过程中获得医疗服务方面的经验。这是一项定性研究,在巴伊亚州的三个城市(一个小城市、一个中等城市和一个大城市)对 18 名妇女进行了调查。数据是通过面对面或在线访谈获得的。使用话语分析技术对经验材料进行了分析。结果显示,在这三个城市中,堕胎是在社会和性别不公正的情况下进行的,低收入妇女更难获得堕胎服务。经济条件较好的妇女可以去秘密的私人诊所堕胎,但不能保证获得人性化的护理。在这三个城市中,经济条件较差的妇女由于面临尴尬和偏见的职业态度而自行堕胎并推迟寻求服务。这些结果表明,迫切需要实施公共政策,使生殖权利与人权一样有效。
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引用次数: 0
Where has the circle taken us? A conversation on sexual health promotion for sex-dissident populations. 圈子把我们带到了哪里?关于促进性异见人群性健康的对话。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-09-18 DOI: 10.1590/1413-81232024299.06162023
Luís Felipe Rios, João Pedro de Souza Dias, Júlio Henrique Magalhães Luckwu

This work discusses the health promotion challenges of men who have sex with men (MSM) through the use of data from a conversation circle with people from institutions that provide services to MSM in the Metropolitan Region of Recife. The results allow for the identification of the following challenges for health promotion work, not only for MSM but also for sex dissidents: difficulties with the use of identity categories, stigmatization for providing them with sexual health care, structural racism, the deprivation of liberty, extreme poverty, and literacy.

本作品通过与累西腓大区为男男性行为者(MSM)提供服务的机构人员进行的对话圈数据,讨论了男男性行为者(MSM)在健康促进方面面临的挑战。研究结果表明,健康促进工作不仅对男男性行为者,而且对性异见者都存在以下挑战:使用身份类别方面的困难、为他们提供性保健服务时受到的侮辱、结构性种族主义、被剥夺自由、极端贫困和扫盲。
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引用次数: 0
Changes in tobacco use and associated factors among Brazilian adolescents: National Student Health Survey. 巴西青少年吸烟情况的变化及相关因素:全国学生健康调查。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-05-08 DOI: 10.1590/1413-81232024299.08252023
Deborah Carvalho Malta, Évelin Angélica Herculano de Morais, Alanna Gomes da Silva, Juliana Bottoni de Souza, Crizian Saar Gomes, Filipe Malta Dos Santos, Cimar Azeredo Pereira

This cross-sectional study used data from Brazil's National Student Health Survey (PeNSE), from 2015 and 2019, to compare consumption of tobacco products among adolescent students in Brazil and identify associated factors. The study variables were current cigarette smoking, use of other tobacco products and use of any tobacco product. Pearson's Chi-square test was used to ascertain associations between the variables; bivariate and multivariate analyses were performed using logistic regression. Cigarette smoking remained stable between 2015 (6.6%) and 2019 (6.8%), but use of any tobacco product increased (from 10.6% in 2015 to 14.8% in 2019), involving particularly hookahs (7.8%) and e-cigarettes (2.8%). Cigarette smoking was greater among adolescents aged 16 and 17, whose skin colour was black or brown, who missed classes without permission, who reported having no friends, displayed other risk factors, such as drinking alcoholic beverages, or who were passive smokers. The prevalence of smoking has increased over the years and is associated with sociodemographic aspects and other health risk behaviour, highlighting the need for lifelong health promotion actions.

这项横断面研究利用2015年和2019年巴西全国学生健康调查(PeNSE)的数据,比较了巴西青少年学生的烟草制品消费情况,并确定了相关因素。研究变量包括当前吸烟、使用其他烟草制品和使用任何烟草制品。采用皮尔逊卡方检验确定变量之间的关联;采用逻辑回归进行二元和多元分析。2015年(6.6%)至2019年(6.8%)期间,吸烟率保持稳定,但使用任何烟草制品的比例都有所上升(从2015年的10.6%上升至2019年的14.8%),尤其是水烟(7.8%)和电子烟(2.8%)。在16和17岁的青少年中,肤色为黑色或棕色、擅自缺课、没有朋友、有其他风险因素(如饮用含酒精饮料)或被动吸烟者的吸烟率更高。吸烟率逐年上升,与社会人口学因素和其他健康风险行为有关,这凸显了采取终身健康促进行动的必要性。
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引用次数: 0
Cyberbullying among Brazilian schoolchildren: data from the National Student Health Survey, 2019. 巴西学童中的网络欺凌:2019年全国学生健康调查数据。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-04-20 DOI: 10.1590/1413-81232024299.19572023
Deborah Carvalho Malta, Juliana Bottoni de Souza, Nadia Machado de Vasconcelos, Flávia Carvalho Malta de Mello, Júlia Bicas Buback, Crizian Saar Gomes, Cimar Azeredo Pereira

This cross-sectional study assessed data from Brazil's 2019 National Student Health Survey to investigate associations between cyberbullying and sociodemographic, family, mental health, and behavioural factors among Brazilian schoolchildren. Multivariate analysis by Poisson regression found 13.2% prevalence of cyberbullying, which was higher among adolescents who felt nobody cared about them (PR=1.47; 1.36-1.59); felt sad (PR=1.5; 1.4-1.7); reported that life was not worth living (PR=1.71; 1.59-1.84); had no friends (PR=1.68; 1.50-1.87); suffered parental aggression (PR=1.54; 1.45-1.65); missed classes without permission (PR=1.13; 1.06-1.20); used tobacco (PR=1.19; 1.10-1.30); alcoholic beverages (PR=1.16; 1.08-1.25); or illicit drugs (PR=1.14; 1.04-1.25); or had sexual intercourse (PR=1.23; 1.14-1.33). Prevalence was lower among boys (PR=0.85; 0.80-0.91); those 16-17 years old (PR=0.88; 0.82-0.95); and who reported having parental supervision in their free time (PR=0.78; 0.73-0.83). Cyberbullying has a high prevalence, highlighting the importance of monitoring this practice and establishing prevention measures in schools.

这项横断面研究评估了巴西 2019 年全国学生健康调查的数据,以调查巴西学童中网络欺凌与社会人口、家庭、心理健康和行为因素之间的关联。通过泊松回归进行的多变量分析发现,网络欺凌的发生率为 13.2%,在以下青少年中发生率更高:觉得没有人关心他们(PR=1.47; 1.36-1.59);感到悲伤(PR=1.5; 1.4-1.7);称生活不值得过(PR=1.71; 1.59-1.84);没有朋友(PR=1.68;1.50-1.87);遭受父母侵犯(PR=1.54;1.45-1.65);擅自缺课(PR=1.13;1.06-1.20);吸烟(PR=1.19;1.10-1.30);喝酒(PR=1.16;1.08-1.25);或非法药物(PR=1.14;1.04-1.25);或发生性行为(PR=1.23;1.14-1.33)。在男孩(PR=0.85;0.80-0.91)、16-17 岁(PR=0.88;0.82-0.95)和报告在空闲时间有父母监督(PR=0.78;0.73-0.83)的人群中,发生率较低。网络欺凌的发生率很高,这凸显了监测这种做法并在学校制定预防措施的重要性。
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引用次数: 0
Indirect victims of violence: a look at health impacts. 暴力的间接受害者:对健康的影响。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-08-20 DOI: 10.1590/1413-81232024299.12082022
Rayana Tavares de Oliveira Bueno, Edinilsa Ramos de Souza, Bruno Costa Poltronieri

We sought to investigate the perceptions of indirect victims or family members of homicide victims, about the repercussions of these deaths on their health. A qualitative, exploratory, descriptive study was carried out, based on eight semi-structured individual interviews with two groups: family members of police officers victimized by lethal violence, and family members of people killed as a result of police intervention, designated here as homicide. Both groups reported the perception that their health deteriorated after the homicide, and mentioned problems such as depression, panic disorder, insomnia, heart conditions and eating disorders. They also highlighted the acquisition of habits that are harmful to health, such as the consumption of alcoholic beverages, tobacco and self-medication, and the worsening of pre-existing health issues. It was observed that the homicide committed and suffered by police agents affects various aspects of the lives of indirect victims that are inseparable from health issues in a broader sense. These people are also victims of this violence, although their suffering is often made invisible. Studying this topic helps to give space to the suffering and mourning of these people and to subsidize the best performance of the institutions and services involved.

我们试图调查凶杀案间接受害者或受害者家属对这些死亡对其健康造成的影响的看法。我们开展了一项定性、探索性和描述性研究,对两组人进行了八次半结构式个人访谈,这两组人分别是:因致命暴力而受害的警察家属,以及因警方干预而被杀害者的家属,在此被称为凶杀案受害者家属。这两组人都报告说,他们认为自己的健康状况在凶杀案发生后有所恶化,并提到了抑郁、恐慌症、失眠、心脏病和饮食失调等问题。他们还强调养成了有害健康的习惯,如饮酒、吸烟和自行用药,以及原有的健康问题恶化。据观察,警察人员犯下的凶杀案和遭受的凶杀影响到间接受害者生活的各个方面,而这些影响与广义上的健康问题密不可分。这些人也是这种暴力的受害者,尽管他们的痛苦往往被忽视。对这一主题的研究有助于为这些人的痛苦和哀悼提供空间,并为相关机构和服务的最佳表现提供补贴。
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引用次数: 0
Comprehensive care for women victims of violence. 为受暴力侵害的妇女提供全面护理。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-10-05 DOI: 10.1590/1413-81232024299.08992023
Patrícia Pereira Tavares de Alcantara, Fernando Ferreira Carneiro, Vanira Matos Pessoa, Antonio Germane Alves Pinto, Maria de Fátima Antero Sousa Machado

Violence against women is defined as any act resulting from gender relations that cause death or physical, sexual, psychological, property and moral harm. Comprehensive care requires professionals understanding the support network to guide and refer women victims of violence to services and to value complaints/anxieties. The objective of this study was to identify the scientific production of comprehensive care for women victims of violence. This is an integrative literature review. Data collection was performed via a paired and independent search by two researchers in the Scopus, PubMed, CINAHL, Web of Science, LILACS, BDENF and SciELO databases between January and February 2023. After applying the eligibility criteria and descriptors in health sciences and medical subject headings, ten articles were retrieved. IRAMUTEQ software was used for data analyses. There are great challenges in implementing comprehensive care, and violence against women, as a serious social problem, demands health, education, social assistance and public security policies. The comprehensive actions taken in the care of women victims of violence demonstrate a strong link with the practices of reception and humanization, in addition to an interdisciplinary and intersectoral scope.

暴力侵害妇女行为被定义为由性别关系导致的任何造成死亡或身体、性、心理、财产和精神伤害的行为。全面关爱需要专业人员了解支持网络,以指导和转介暴力受害妇女获得服务,并重视投诉/焦虑。本研究的目的是确定为暴力受害妇女提供全面护理的科学成果。这是一项综合性文献综述。数据收集工作由两名研究人员于 2023 年 1 月至 2 月期间在 Scopus、PubMed、CINAHL、Web of Science、LILACS、BDENF 和 SciELO 数据库中进行配对和独立检索。在应用资格标准和健康科学与医学主题词描述后,共检索到 10 篇文章。数据分析采用 IRAMUTEQ 软件。实施全面关爱面临巨大挑战,暴力侵害妇女作为一个严重的社会问题,需要卫生、教育、社会 援助和公共安全政策。为照顾受暴力侵害的妇女而采取的综合行动表明,除了跨学科和跨部门范围外,还与接待和人 道化做法密切相关。
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引用次数: 0
Domestic violence, obesity and malnutrition in elderly people in a capital in southern Brazil - EpiFloripa Idoso Study. 巴西南部首府老年人的家庭暴力、肥胖和营养不良--EpiFloripa Idoso 研究。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-04-19 DOI: 10.1590/1413-81232024299.16462023
Carolina Abreu Henn de Araújo, Deise Warmling, Pierre Guedes Araújo, Elza Berger Salema Coelho

The objective of this article was to verify the association between domestic violence and obesity and malnutrition in elderly people in Florianópolis, Santa Catarina, Brazil. Cross-sectional study evaluated in the EpiFloripa Elderly cohort in 2013/2014. The outcomes were body mass index (BMI) and abdominal obesity (increased WC). Violence against elderly people was measured using the HawlekSengstock Elder Abuse Screening Test (H-S/EAST) instrument, and IPV using the Conflict Tatics Scales Form R (CTS-1) instrument. Logistic regression and multinomial logistic regression models were used. It was observed that men had a greater chance of abdominal obesity when in situations of violence and in the potential abuse dimension. Women were more likely to have abdominal obesity in the dimension of violation of personal rights or abuse, when they suffered IPV and when they were perpetrators of IPV. In relation to BMI, elderly women in situations of violence were associated with a greater chance of being overweight and those who suffered IPV. On the other hand, men in vulnerable situations were more likely to be underweight. It is concluded that violence against elderly people and IPV generate an asymmetric impact on nutritional status in relation to sex.

本文旨在验证家庭暴力与巴西圣卡塔琳娜州弗洛里亚诺波利斯市老年人肥胖和营养不良之间的关系。横断面研究对2013/2014年EpiFloripa老年人队列进行了评估。研究结果为体重指数(BMI)和腹部肥胖(腹围增加)。针对老年人的暴力行为使用Hawlek-Sengstock老年人虐待筛查测试(H-S/EAST)工具进行测量,IPV使用冲突量表R表(CTS-1)工具进行测量。研究采用了逻辑回归和多项式逻辑回归模型。结果表明,在暴力情况和潜在虐待维度中,男性腹部肥胖的几率更大。而在侵犯个人权利或虐待维度、遭受 IPV 和实施 IPV 时,女性腹部肥胖的几率更高。就体重指数(BMI)而言,遭受暴力侵害的老年妇女和遭受 IPV 的老年妇女超重的几率更大。另一方面,处于弱势地位的男性则更有可能体重不足。结论是,针对老年人的暴力和 IPV 对营养状况的影响与性别不对称。
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引用次数: 0
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