Brazil is the first country in the world to have broad coverage standard (NR-32) focused on protecting health workers exposed to biological risks. This study evaluated the degree of knowledge of the NR-32 Standard and the level of knowledge and compliance with the standard precautions. A cross-sectional study was conducted with 208 randomly selected health professionals; 93 of them were residents and 115 were physicians at a Brazilian Clinical Hospital. To collect information, the participants were interviewed and/or they completed semi-structured questionnaires divided into three domains: knowledge of the standard, knowledge of biosafety, and compliance with standard precautions. Cronbach's alpha was used to assess internal consistency of the scales of knowledge and compliance with values above +0.75 indicating excellent agreement. Multivariate linear regression was used to evaluate the predictors for compliance with NR-32, biosafety, and standard precautions. Mean knowledge of the NR-32 Standard was 2.2 (± 2.02) points (minimum 0 and maximum 7 points). The minimum expected mean was 5.25 points. The mean knowledge of biosafety was 12.31 (± 2.10) points (minimum 4 and maximum 16 points). The minimum expected mean was 12.75 points. The mean compliance with standard precautions was 12.79 (± 2.6) points (minimum 6 and maximum 18 points). The minimum expected mean was 13.5 points. The individual means for using gloves, masks and goggles during procedures and for not recapping needles were 2.69, 2.27, 1.20 and 2.14, respectively. The factors associated with knowledge of the NR-32 were: greater knowledge amongst those who studied at a public university and who had knowledge of biosafety. The knowledge of the NR-32 Standard was low, but there was a good level of knowledge of biosafety issues. The compliance with standard precautions was acceptable in general, but was low for some of the evaluated precautions.
Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.
ObjectiveThe objective of this study was to evaluate the prevalence and incidence of accidents with biological material, the level of knowledge, and compliance to standard precautions (SPs) among dentists, physicians, nurses, and dental and medical students.MethodsA closed cohort study with a prospective and retrospective component was conducted between August 2014 and September 2015. The participants were contacted in two moments during the follow-up period, during which a structured questionnaire divided into six sections was used; the interviews were conducted during the follow-up period (Month 6) and at the end of the observation period (Month 12).ResultsThe global prevalence of accidents in the previous 12 months was 10.2%, with a difference between professionals and students (13.0% vs. 5.1%, respectively; p < 0.003). The incidence rate was 6.49 per 100 person/year, with difference between the groups (6.09 per 100 person/year in professionals and 7.26 per 100 person/year in students), type of specialization (hazard ratio, 3.27), and hours worked per week (hazard ratio, 2.27). The mean of compliance to SP was 31.99 (±3.85) points, with a median of 33 (30, 35) points against the expected 27.75 points. Adherence to SP was associated with the accident report (p < 0.020).ConclusionWe conclude that the proportion/incidence rate of accidents with biological material was high in relation to that in the literature, being higher in professionals and especially among physicians. The levels of knowledge and adherence to SP were good, with the best found in dentists and dental students.
Objective: to analyze the survival of people with AIDS and association with schooling and race/skin color. Methods: this was a retrospective cohort study of people diagnosed with AIDS between 1998 and 1999, in the South and Southeast regions of Brazil. We used survival analysis (Kaplan-Meier method), stratified by schooling and race/skin color and multivariate analysis was performed using Cox regression. Results: the study included 2,091 people who had survived at 60 months, with 65% survival among White participants and 62% among Black/brown participants. Irregular use of antiretroviral (HR=11.2-95%CI8.8;14.2), and age ≥60 years (HR=2.5-95%CI1.4;4.4) were related to lower survival; schooling >8 years (HR=0.4-95%CI0.3;0.6) and being female (HR=0.6-95%CI0.5;0.8) were positively related to survival; those with less schooling had lower survival. Conclusion: lower schooling levels overlap race/skin color differences in relation to survival; these inequalities explain the differences found, despite the policies on universal access to antiretroviral.
BackgroundSeveral diseases may lead to the need for liver transplantation due to progressive organ damage until the onset of cirrhosis, resulting in changes in interpersonal relationships. Social Support for transplant candidates is an important variable, providing them with psychological and social well-being. This study aims to assess social support in chronic hepatic patients, waiting for liver transplantation.MethodsA cross-sectional study was conducted with 119 patients, for convenience sampling, from the liver transplant waiting list at a Brazilian University Hospital Outpatients. The information was collected through semistructured questionnaires, in four stages: 1) socioeconomic and demographic information 2) clinical aspects 3) feelings 4) Social Support Network Inventory (SSNI), to Brazilian Portuguese. The statistical analysis was conducted using ANOVA and multivariate linear regression analysis to evaluate the relationship between the scales of social support and the collected co-variables.ResultsAverage age was 50.2 ± 11.6, and 87 (73.1%) were men. Patients with alcohol and virus liver disease etiology had the same frequency of 28%. The MELD, without extrapoints, was 16.7 ± 4.9. Global social support family score was 3.72 ± 0.39, and Cronbach’s alpha = 0.79. The multivariate analysis presented the following associations, age = [− 0.010 (95% CI = − 0.010 - -0.010); P = 0.001], etiology of hepatic disease = [− 0.212 (95% CI = − 0.37 - -0.05); P = 0.009], happiness = [− 0.214(95% CI = − 0.33 - -0.09) P = 0.001) and aggressiveness = [0.172 (95% CI = 0.040–0.030); P = 0.010).ConclusionsThe social support was greater when the patients were younger (18 to 30 years). Patients with alcoholic cirrhosis, regardless of whether or not they were associated with virus, had less social support. As for feelings, the absence of happiness and the presence of aggressiveness showed a negative effect on social support.
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