https://tedebc.ufma.br/jspui/handle/tede/1093 2026-04-10T03:20:25Z 2026-04-10T03:20:25Z LOPES, Ana Beatriz Alves https://tedebc.ufma.br/jspui/handle/tede/6806 2026-03-02T14:05:45Z 2026-01-29T00:00:00Z

Título: DESENVOLVIMENTO DE APLICATIVO MÓVEL PARA ACOMPANHAMENTO DE COMPLICAÇÕES EM PACIENTES HIPERTENSOS E DIABÉTICOS ACOMETIDOS POR COVID-19 NA ATENÇÃO PRIMÁRIA À SAÚDE Autor: LOPES, Ana Beatriz Alves Primeiro orientador: ANDRADE, Yara Naya Lopes de Abstract: Introduction: Systemic Arterial Hypertension and Diabetes Mellitus constitute noncommunicable chronic diseases with high prevalence and significant impact on morbidity and mortality, especially when associated with COVID-19 infection, whose interaction potentiates the risk of cardiovascular, renal, and metabolic complications. Within the Primary Health Care context, the pandemic imposed important challenges to the longitudinal follow-up of these patients, highlighting difficulties in care continuity and systematization of post-infection clinical monitoring. From this scenario, the delimitation of the research object was supported by the application of the GUT Matrix (Gravity, Urgency, and Tendency), a tool that enabled systematic analysis of problems faced within Primary Health Care. Therefore, the study sought to answer "What functionalities, content, and technical characteristics should comprise a mobile application aimed at monitoring complications in hypertensive and diabetic patients affected by COVID-19 within Primary Health Care?" Objective(s): To develop a mobile application for monitoring complications in hypertensive and diabetic patients who were affected by COVID-19. Methodological Procedures: This is a technological production study with a quantitative approach, supported by software engineering and grounded in the systems development life cycle. To achieve the proposed objectives, this research stage followed the following phases: Stage 1 – Scoping Review, entitled “Mapping mobile applications for monitoring chronic conditions in patients previously affected by COVID-19 in primary health care: a scoping review”, which was submitted and registered on the OSF platform using the OSF pre-registration model, under the identifier DOI: 10.17605/OSF.IO/29C5Q; Stage 2 – Requirements Gathering for mobile technology structuring; Stage 3 – Development of the Technological Production Life Cycle. Results: The synthesis of the ten studies included in the Scoping Review revealed that mobile technologies designed to monitor people with hypertension and diabetes mellitus predominantly present fragmented functional organization, a focus on punctual records of clinical parameters and self-management strategies, limitations in the incorporation of longitudinal care, and low integration between clinical, laboratory, and follow-up data. Based on these findings, the clinical, functional, and operational requirements considered essential for the construction of the technology were systematized, encompassing blood pressure and blood glucose monitoring, structured recording of post-COVID-19 signs and symptoms, evolutionary monitoring of tests and medications, as well as resources for risk stratification, longitudinal visualization, and organization of clinical follow-up. Thus, the Cronicov mobile application was developed, structured according to an architectural model guided by agile methodology in the context of Primary Health Care. Conclusions: The mobile application development transformed a concrete Primary Health Care need into a technological solution for monitoring people with hypertension and diabetes affected by COVID-19. Despite challenges in organizing information and care flows, it was possible to build a structured tool with potential for use in team routines. The study objective was achieved, recognizing, however, the need for validation, usability evaluation, and impact measurement. Thus, the work contributes both as a technological product and by presenting a methodological pathway applicable to the integration of research, technology, and health practice within the Unified Health System. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação; Trabalho sob Sigilo. Motivo: Não Informado pelo Autor. Data Provável de Liberação:31 de janeiro de 2028.

2026-01-29T00:00:00Z GONÇALVES, Heloisa Maria Lima https://tedebc.ufma.br/jspui/handle/tede/6794 2026-02-25T13:37:55Z 2019-09-27T00:00:00Z

Título: Distribuição espacial da cobertura vacinal contra o HPV no Maranhão Autor: GONÇALVES, Heloisa Maria Lima Primeiro orientador: CALDAS, Arlene de Jesus Mendes Abstract: Vaccination coverage (CV) is an important indicator of population health and the quality of care provided by basic health services. It is estimated that one in ten people are infected with Human Papillomavirus (HPV) and, it is a virus known to cause cervical cancer, in addition to being related to several other types of cancer. The objective is to describe the spatial distribution of vaccination coverage against HPV in Maranhão. This is an ecological, descriptive study on vaccination coverage against HPV in the State of Maranhão between 2017 and 2018, with the municipalities as the unit of analysis, the target audience was female (9 to 14 years old) and the male (11 to 14 years old), who received the doses of the HPV vaccine during the study period, registered in the Information System of the National Immunization Program (SI-PNI) and in the database of the state department of Immunization, of the State Health Secretariat. A descriptive analysis of vaccination coverage was carried out by municipalities in Maranhão, using maps according to sex, age, followed by the study of the spatial pattern. It was observed that in the year 2017, 736,430 individuals were able to receive the HPV vaccine in the state of Maranhão; of these, only 30.99% females and 39.42% males received the vaccine; in 2018, 736,436 individuals were able to receive the HPV vaccine, with only 21.99% females and 31.79% males receiving the vaccine. The findings presented suggest low coverage and heterogeneity in the doses of the HPV vaccine in the state of Maranhão. It is concluded that vaccination coverage against HPV in the municipalities in Maranhão is low in relation to the goal advocated by the Ministry of Health and that there are significant differences in coverage by sex, age and municipalities, therefore requiring greater direction in the vaccination strategy. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

2019-09-27T00:00:00Z CARVALHO, Jéssica Pereira Alves de https://tedebc.ufma.br/jspui/handle/tede/6772 2026-02-11T12:38:54Z 2026-01-30T00:00:00Z

Título: Construção e validação de software para consulta de enfermagem à pessoa com diabetes mellitus na atenção primária à saúde Autor: CARVALHO, Jéssica Pereira Alves de Primeiro orientador: PASCOAL, Lívia Maia Abstract: Information and Communication Technologies have been the subject of study in nursing, especially in Primary Health Care, due to their potential to improve the quality of care, strengthen health promotion actions, disease prevention, and the monitoring of chronic conditions such as Diabetes Mellitus. In this context, this study aimed to develop and validate the content and appearance of a software prototype to support nurses in conducting nursing consultations for people with Diabetes Mellitus in Primary Health Care. This is a methodological study, grounded in the software engineering approach proposed by Pressman and Maxim, structured into three phases according to the Unified Process Model. The first phase, Conception, involved planning and defining goals, the central theme, technological resources, and the project team. The second phase, Elaboration, included a literature review and the results of an analysis of interviews conducted in a previous study with professionals working in the Family Health Strategy, ensuring alignment with the principles of User-Centered Design. The scientific evidence gathered, combined with the identified practical demands, supported the definition of the content incorporated into the technology, enabling the development of the software prototype. The third phase, Construction, consisted of content and appearance validation, as well as the development of the final version of the prototype. Specialists were selected according to Jasper’s criteria. Validation was carried out using the Suitability Assessment of Materials (SAM) instrument, with screen organization divided into three blocks. The study was approved by the Research Ethics Committee under approval number 7,934,746. The prototype was developed between December 2024 and October 2025 and was named Diabetes.check: Guide for Nursing Consultation. Initially, the prototype comprised a structure of 77 screens, distributed among user identification and access, main interface, functionalities, and the development and management of the care plan. The main screens contained 14 structured topics, organized to facilitate the systematic conduct of the nursing consultation, including tabs dedicated to clinical history, history of present illness, lifestyle habits, physical examination, foot examination, nursing diagnoses, interventions, and outcomes. For content and appearance validation, nine specialists participated, all nurses, predominantly holding master’s and doctoral degrees. The SAM instrument scores indicated percentages of 90.7% in Block 1, 94.2% in Block 2, and 94.4% in Block 3, classifying the material as of superior quality. The Content Validity Indices were 0.80, 0.90, and 0.92 for Blocks 1, 2, and 3, respectively, demonstrating excellent agreement among the specialists. The suggestions provided were incorporated, resulting in a final version composed of 80 screens. The content and appearance validation process showed a high level of agreement among the specialists, proving to be essential for improving the prototype. Diabetes.check is configured as an innovative technology with the potential to contribute to the systematization of nursing consultations for people with Diabetes Mellitus, support clinical reasoning, and promote safe, efficient, and evidence-based nursing practice in Primary Health Care. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação; Documento sob sigilo. Prazo provável para disponibilização total: 5 anos. Motivo do sigilo: proteção intelectual da tecnologia desenvolvida.

2026-01-30T00:00:00Z MARGALHO, Maria de Nazaré Lima https://tedebc.ufma.br/jspui/handle/tede/6765 2026-02-09T13:15:11Z 2026-01-28T00:00:00Z

Título: Diabetes Mellitus na Atenção Primária à Saúde de Imperatriz – MA: Aspectos clínico-epidemiológicos e distribuição espaço-temporal Autor: MARGALHO, Maria de Nazaré Lima Primeiro orientador: FONTOURA, Iolanda Graepp Abstract: Introduction: Diabetes mellitus (DM) is a significant public health issue, characterized by high prevalence, morbidity, mortality, and socioeconomic impact, especially within the scope of Primary Health Care (PHC). In contexts marked by social inequalities, such as the Brazilian Northeast, clinical-epidemiological analysis combined with spatial approach helps identify priority areas and more vulnerable groups. Objective: To analyze the clinical-epidemiological aspects and spatial distribution of DM cases in PHC in the municipality of Imperatriz, Maranhão, from 2020 to 2024. Methodology: Ecological study with distinct analytical measures, conducted from secondary data collected in January 2025 through the e-SUS/PHC system, provided by the PHC Superintendence of the municipality. Clinical-epidemiological context variables were evaluated using descriptive statistics, with both absolute and relative values expressed. Poisson regression models, prevalence ratios, and their respective 95% confidence intervals were estimated using Rstudio® version 2025.05.0, with a significance level set at 5%. Semiannual prevalence was determined in percentage values over the analyzed period, and its trend was assessed using the Joinpoint Regression Program software, version 5.2.0.0. Cases were georeferenced from complete addresses and geographic coordinates, using the Geocode by Awesome Table® plugin integrated with Google®. Subsequently, they were distributed across the census sectors of the municipality and spatially analyzed by Kernel density in QGIS® version 3.34.8. The study was approved by the Ethics Committee of the Federal University of Maranhão under opinion number 7.239.338. Results: A total of 17,761 cases were recorded, predominantly type 2 DM (88.5%), women (60.0%), individuals aged 60 years or older (54.7%), mixed-race (63.8%), with incomplete elementary education (52.6%) and adequate weight (66.7%). The most frequent comorbidity was systemic arterial hypertension (SAH) (54.7%). Most patients were non-smokers and had no complications such as stroke (CVA) or acute myocardial infarction (AMI). There was a high proportion of missing data, particularly regarding marital status (91.6%). In the multivariate analysis, factors associated with death included age ≥ 60 years, cancer, COPD, and occurrence ofstroke, all with significantly elevated risk. The DM prevalence in Imperatriz ranged from 0.5% in 2020 to 4.3% in 2023, with an average of 2.27%, showing an initial increase followed by a decrease to 1.6% in 2024. The overall trend was stable, with growth between 2020/1–2023/1 (+48.37%) and decline between 2023/1–2024/1 (-30.03%). Approximately 90% of DM cases (15,980) were geocoded, with 92% concentrated in urban census sectors. The application of the Kernel technique revealed heterogeneous and non-random distribution, with areas of high density primarily in the neighborhoods of Centro, Nova Imperatriz, Bacuri, and Juçara. Conclusion: The findings revealed the predominance of DM in the population, with higher rates among the elderly, women, mixed-race individuals, low education, and those comorbid with SAH, predominating over type 2 DM, with an intra-urban concentration of cases. These findings support decision-making, guide resource allocation, and define territorial care priorities, reaffirming the central role of PHC in addressing DM. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação; Trabalho sob sigilo. Motivo: Prever plágio, os autores futuramente irão publicar artigos. Data Provável de Liberação: 18 meses.

2026-01-28T00:00:00Z