https://tedebc.ufma.br/jspui/handle/tede/673 2026-05-05T23:31:54Z 2026-05-05T23:31:54Z RODRIGUES, Evandicleude Ferreira de Carvalho https://tedebc.ufma.br/jspui/handle/tede/6937 2026-05-04T14:09:31Z 2026-03-27T00:00:00Z

Título: O ensino de epidemiologia nos cursos de graduação em Enfermagem do Brasil Autor: RODRIGUES, Evandicleude Ferreira de Carvalho Primeiro orientador: OLIVEIRA, Bruno Luciano Carneiro Alves de Abstract: Introduction: Epidemiology constitutes an essential foundational component in the education of nurses. However, significant gaps remain in the knowledge regarding the provision of this discipline within undergraduate Nursing programs at Brazilian higher education institutions. Objective: To analyze the teaching of Epidemiology in the pedagogical projects of undergraduate Nursing programs at public higher education institutions in Brazil. Methods: This was a cross-sectional, document-based study employing a qualitative-quantitative approach. Data was collected from the Pedagogical Projects of Undergraduate Nursing Programs at public higher education institutions in Brazil. A total of 124 programs from 87 higher education institutions were included. Eligible institutions were officially accredited and registered in the e-MEC system, had a score equal to or higher than 3 in the 2023 National Student Performance Examination (ENADE), and had their pedagogical project publicly available. Quantitative data were analyzed using descriptive statistics with support from Microsoft Excel and RStudio software. Qualitative analysis was conducted using Bardin’s content analysis framework, supported by IRaMuTeQ software for data coding, categorization, and thematic class generation. Results: Epidemiology was identified in all programs analyzed. However, substantial variability was observed in its curriculares organization. In most institutions (72.2%), epidemiology was offered as a standalone discipline, whereas in others (27.8%), it was integrated into thematic axes related to Public Health, Biostatistics, and Health Surveillance. Additional variations were identified in course workload, year of offering, and types of bibliographic references adopted. Content analysis revealed three thematic classes. Terms related to epidemiological indicators, measures, and analytical methods predominated (49%), followed by content addressing the application of Epidemiology to health planning, management, and practice (38.6%). Expressions associated with health conditions and determinants of the health–disease process in Public Health appeared less frequently (12.4%). Statistically significant regional differences were observed among thematic classes (p-value = 0.012). The theoretical-descriptive dimension of the discipline was the most prevalent nationwide (73.0%), particularly in programs located in the North and Northeast regions. Approaches emphasizing health planning and management, either independently or integrated with the quantitative applicability of the discipline, were more predominant in the Midwest, Southeast, and South regions. Only five programs nationwide included all thematic classes within their course syllabi. Conclusion: The study demonstrates heterogeneity in the teaching of Epidemiology in public undergraduate Nursing programs in Brazil. Although the discipline is present in all analyzed programs, there is variability in curricular organization and a predominance of a conceptual and technical-operational approach in course syllabi, to the detriment of discussions addressing public health conditions and determinants. This scenario may pose challenges to the comprehensive education of nurses. The incorporation and integration of thematic classes, longitudinal distribution of the discipline throughout the curriculum, and strengthening of its critical-analytical depth across different stages of training emerge as strategies to reinforce a comprehensive perspective of Epidemiology and to reduce fragmentation in undergraduate Nursing education in Brazil. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

2026-03-27T00:00:00Z CRUZ, Pablo Nascimento https://tedebc.ufma.br/jspui/handle/tede/6924 2026-04-23T13:41:23Z 2026-03-06T00:00:00Z

Título: ESPACIALIZAÇÃO, TENDÊNCIA TEMPORAL E FATORES ASSOCIADOS À MORTALIDADE FEMININA POR CÂNCER DE MAMA NA AMAZÔNIA LEGAL Autor: CRUZ, Pablo Nascimento Primeiro orientador: RABÊLO, Poliana Pereira Costa Abstract: Objective: To analyze the spatial dynamics, temporal trends, and factors associated with female mortality from breast cancer in the Brazilian Legal Amazon. Method: This is an ecological study on breast cancer mortality among women aged 20 years or older. Records of deaths occurring in the Legal Amazon between 2014 and 2023 were included, collected from January to May 2025. The data sources were: TABNET/DATASUS, Brazilian Institute of Geography and Statistics, Atlas of Human Development in Brazil, and IPS Brazil. Mortality rates were standardized using the direct method (SMR), based on the female population from the 2022 demographic census, with correction for ill-defined causes. The ecological units for temporal analysis were the states, and for spatial analysis, the health regions (HR). Temporal trends in sociodemographic characteristics and SMR were assessed using Joinpoint Regression, estimating Annual Percent Change (APC). Spatial analysis was performed using Global Moran’s Index, Local Moran’s Index (LISA Map), and spacetime scan statistics. The association between the dependent variable (SMR) and socioeconomic and healthcare indicators, based on the Social Determinants of Health (SDH) framework, was assessed through multivariate linear regression (OLS), Spatial Error Model (SEM), and Spatial Lag Model (SAR). Results: A total of 12,034 deaths were recorded during the study period. The average SMR for the Legal Amazon was 18.6 per 100,000 women, with the highest rates observed in Mato Grosso (SMR=21.7), Amazonas (SMR=21.4), and Roraima (SMR=20.3). An increasing trend was observed in the Legal Amazon (APC=2.17), Maranhão (APC=1.85), and Roraima (APC=9.97), as well as among the following groups: women aged ≥80 years, with 8 or more years of schooling, separated, and Black women after 2020. Conversely, declining trends were identified among women aged 30–39 years from 2018 onward, and among those aged 40–49 years, with 0–3 years of schooling and married. Significant spatial autocorrelation was found (I=0.218; p=0.002), and local analysis indicated “High-High” clusters in Mato Grosso, “Low-Low” clusters in Maranhão, Pará, and Amazonas, and outliers in areas of epidemiological transition. The space-time scan identified 10 clusters, including 4 protective clusters in Maranhão, Tocantins, Pará, Roraima, Amazonas, and Acre, and 6 risk clusters in Mato Grosso, Roraima, Amazonas, and Pará. Positive associations of SMR were found with aging rate (β=0.899), household per capita income (β=0.022), and number of nurses (β=0.004), while an inverse effect was observed for expected years of schooling (β=-2.101). Conclusion: The geographic and temporal disparities identified in mortality patterns underscore the relevance of SDH and highlight the need for more targeted public policies aimed at improving access to healthcare services. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

2026-03-06T00:00:00Z PEREIRA, Girlane Caroline https://tedebc.ufma.br/jspui/handle/tede/6789 2026-02-24T12:28:56Z 2025-12-22T00:00:00Z

Título: Avaliação do uso tópico da ALOE vera no reparo tecidual de feridas crônicas Autor: PEREIRA, Girlane Caroline Primeiro orientador: DIAS, Rosilda Silva Abstract: Introduction: The management of chronic wounds represents a persistent challenge in healthcare services, requiring therapeutic alternatives that are effective, safe, and accessible. Aloe vera (L.) Burm. f. stands out in phytotherapy due to its anti- inflammatory, antioxidant, and regenerative properties, being considered a promising option in the wound healing process. Objective: To evaluate the clinical and histological effects of the topical application of in natura Aloe vero gel on the tissue repair of chronic wounds of different etiologies. Methods: This is a descriptive, quantitative, longitudinal case series clinical study conducted from August to October 2025 in a specialized outpatient clinic for the care of people with chronic wounds, linked to a public hospital in the municipality of São Luís, Maranhão, Brazil. Follow-up included serial clinical evaluations and comparative histological analysis at baseline (Day 0) and at the end (Day 15), aiming to analyze tissue and cellular evolution. Results: Favorable clinical evolution was observed in all participants, characterized by reduction of exudate, improvement in wound bed appearance, progression of epithelialization, and decreased pain intensity. In three participants, complete formation of granulation tissue was observed at the end of the follow-up period. Histological analysis corroborated the clinical findings, showing reduced inflammatory infiltrate, increased angiogenesis, and proliferation of young fibroblasts, consistent with progression to the proliferative phase of tissue repair. Conclusion: The topical use of in natura Aloe vera gel demonstrated positive effects on tissue repair and pain control in chronic wounds, representing a safe, low-cost, and potentially relevant therapeutic alternative for nursing practice. The findings indicate the feasibility of incorporating this approach as a complementary strategy in the care of chronic wounds within the Unified Health System (SUS). Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

2025-12-22T00:00:00Z CARVALHO, Wildilene Leite https://tedebc.ufma.br/jspui/handle/tede/6778 2026-02-20T14:25:24Z 2025-12-16T00:00:00Z

Título: Avaliação da sepse em terapia intensiva: análise dos dados clínico-laboratoriais e diagnósticos de enfermagem NANDA Internacional Autor: CARVALHO, Wildilene Leite Primeiro orientador: SILVA, Andréa Cristina Oliveira Abstract: Sepsis remains one of the major challenges in Intensive Care Units, characterized by high morbidity and mortality and complex care demands. This study aimed to analyze clinical and laboratory data and NANDA-I nursing diagnoses recorded in the medical records of patients diagnosed with sepsis and septic shock in an adult Intensive Care Unit. This was a documentary, analytical, and retrospective study with a quantitative approach, conducted using medical records of patients admitted between 2022 and 2024 and approved by the Research Ethics Committee under protocol number 7,589,331. A total of 78 medical records were analyzed. The results showed a predominance of female patients and older adults (age range: 20 to 83 years), as well as significant hemodynamic instability, with frequent need for mechanical ventilation, vasopressor therapy, and invasive devices. The main infectious foci were ventilator- associated pneumonia and catheter-associated bloodstream infection. Microbiological analysis revealed a predominance of multidrug-resistant Gram-negative bacilli, including Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, in addition to a relevant presence of Candida species. Antimicrobial therapy predominantly involved broad-spectrum agents, reflecting the resistance profile identified. The most frequent nursing diagnoses were Risk for Infection, Risk for Pressure Injury in Adults, Impaired Spontaneous Ventilation, and Impaired Self-Care Syndrome. After applying the False Discovery Rate adjustment, fourteen associations between nursing diagnoses and categorical variables remained statistically significant. Among continuous variables, a strong correlation was observed between urea and creatinine levels, and a moderate correlation between SOFA score and creatinine. For the nursing diagnosis Risk for Infection – Invasive Procedure, elevated bilirubin levels and the presence of septic shock were identified as strong predictors. Receiver operating characteristic curve analysis demonstrated that this diagnosis showed the highest accuracy among the tested models, indicating its potential as a useful predictive tool in clinical practice. It is concluded that sepsis in intensive care settings presents an etiology predominantly associated with the hospital environment and requires integrated action by the multidisciplinary team. The findings reinforce the strategic role of nurses in the Nursing Process, particularly in clinical surveillance, early risk identification, and diagnostic accuracy. Overall, the results highlight that certain nursing diagnoses have relevant predictive value, standing out as clinical judgments capable of anticipating clinical deterioration and supporting decision-making in patients with sepsis. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

2025-12-16T00:00:00Z