https://repositoriobce.fepecs.edu.br/handle/prefix/1 Espaço de compartilhamento da produção científica, intelectual e técnica dos cursos de graduação, especialização, pós-graduação, extensão e curso técnico das escolas ESCS, ESP/DF. Mon, 19 Oct 2026 22:34:57 GMT 2026-10-19T22:34:57Z http://repositoriobce.fepecs.edu.br:80/retrieve/321961cc-721d-4e89-a81a-ef1d67c4e70d/Memória Institucional (4).png https://repositoriobce.fepecs.edu.br/handle/prefix/1 https://repositoriobce.fepecs.edu.br/handle/123456789/1722 Título: Avaliação do conhecimento sobre câncer de pele em profissionais da saúde e pacientes na atenção primária de saúde do Distrito Federal Autor(es): Machado, Daniela Silva Primeiro Orientador: Reis, Carmélia Matos Santiago Abstract: Introduction: Skin cancer is one of the main contemporary public health challenges, presenting high incidence and significant socioeconomic impact. In the Brazilian context, non-melanoma skin cancer (NMSC) is the most frequent malignant neoplasm, representing approximately 33% of all cancer records in the country. Given the severity of the disease and its curative potential when detected early, Primary Health Care (PHC) plays a strategic role as the coordinating pillar of the network and the gateway for screening and health education. However, the effectiveness of this control may be limited by gaps in the technical knowledge of teams and in the population's perception of risk. Objectives: To evaluate the knowledge of physicians and nurses working in the PHC of the Federal District, Brazil, regarding skin cancer diagnosis, prevention, and risk factors, as well as to investigate the level of information and preventive practices of the population assisted in these units. Method: An observational, analytical, quantitative, and cross-sectional study conducted in 14 Basic Health Units (UBS) covering the seven health regions of the Federal District. The sample consisted of 122 professionals (G1) – physicians and nurses - and 150 patients (G2). Data were collected via in-person questionnaires addressing sociodemographic variables, theoretical knowledge, clinical practices, screening tools (such as the ABCDE mnemonic), and risk factors. Statistical analysis used Pearson's Chi-square test and Student's t-test, with a significance level of 5%, classifying as "satisfactory" a score of 50% or more on the objective questionnaire items. Results: Among health professionals, 67.21% presented unsatisfactory knowledge on the subject. Only 7.38% reported routinely performing skin physical examinations, and 54.10% were unfamiliar with the ABCDE method. It was found that physicians have significantly higher chances of identifying suspicious lesions (O.R.=5.610) and knowing the ABCDE method (O.R.=4.800) compared to nurses. In the patient group, 80% demonstrated unsatisfactory knowledge. The main sources of information were television (49.62%) and the internet (45.11%), while only 16.54% received guidance during consultations. Alarmingly, 74.67% of users stated their skin had never been examined at the UBS, and 86% were never guided on how to perform a skin self-examination. Obstacles such as lack of time (53.28%) and lack of specific training (54.10%) were the most cited difficulties by professionals. Conclusions: The study highlights a critical deficit in technical proficiency and preventive care practices related to skin cancer in the Federal District. Academic background and length of service proved to be determinants of the level of knowledge, revealing asymmetries between professional categories. Regarding patients, the lack of knowledge about the subject—as well as prevention methods—is even more pronounced, underscoring the inadequacy of health education within Primary Health Care (PHC). The implementation of Continuing Health Education (CHE) programs, standardization of active visual screening protocols, and the strengthening of the UBS as a primary source of scientific education are urgently needed to optimize early diagnosis and increase survival rates for SUS users. Editor: Escola Superior de Ciências da Saúde Tipo: Dissertação Mon, 27 Jul 2026 00:00:00 GMT https://repositoriobce.fepecs.edu.br/handle/123456789/1722 2026-07-27T00:00:00Z https://repositoriobce.fepecs.edu.br/handle/123456789/1721 Título: Transmissão vertical do vírus linfotrópico de célula T humana (HTLV) no Distrito Federal: uma realidade? Autor(es): Luz, Beatriz Maciel Primeiro Orientador: Imoto, Aline Mizusaki Abstract: Introduction: Human T-cell lymphotropic virus (HTLV) is a retrovirus associated with severe diseases, including adult T-cell leukaemia/lymphoma and HTLV-1-associated yelopathy/tropical spastic paraparesis, as well as other inflammatory, neurological, dermatological, ophthalmological and infectious conditions. Infection may remain asymptomatic for many years, contributing to silent transmission and to the maintenance of family and community transmission chains. HTLV can be transmitted sexually, through blood exposure and vertically from mother to child. Vertical transmission is one of the main routes of viral spread in endemic areas, especially when breastfeeding is prolonged. The absence of a vaccine or curative treatment reinforces the importance of preventive strategies, particularly antenatal screening, adequate counselling, avoidance of breastfeeding, use of lactation inhibitors and provision of infant formula. In Brazil, antenatal screening for HTLV was incorporated into the Unified Health System in 2024. However, the Federal District has offered HTLV testing to pregnant women attending the public health system since 2013. This pioneering experience includes screening using dried blood spot samples, confirmatory testing in serum samples and recommendations to prevent vertical transmission, such as contraindication of breastfeeding, use of cabergoline and provision of infant formula for exposed infants up to 12 months of age. Despite these advances, professional practice revealed important gaps in the organization of care, particularly regarding counselling for pregnant women, timely access to infant formula, follow-up of exposed children and the availability of specific educational materials to support communication between health professionals and women living with HTLV. The research problem originated directly from the author’s professional practice at the Sexually Transmitted Infections Surveillance Management Unit of the Health Department of the Federal District, the technical area responsible for surveillance, monitoring and coordination of prevention actions related to HTLV and other sexually transmitted infections. In the daily practice of public health management and epidemiological surveillance, it was observed that, although the Federal District had been testing pregnant women for more than a decade, there were no systematized data on the occurrence of vertical transmission among children born to women diagnosed during antenatal care. There was also a need to produce educational materials to support health professionals and pregnant women in understanding the infection, its modes of transmission, preventive measures and care pathways. Therefore, this dissertation was structured in a multipaper format, combining scientific production and a Technical-Technological Product, with a focus on generating evidence and applying results to the Brazilian Unified Health System. Objective: To analyse HTLV vertical transmission in the Federal District, Brazil, based on the epidemiological characterization of pregnant women diagnosed during antenatal care and their exposed children, and to develop scientific and technical-educational products aimed at improving care, preventing vertical transmission, and strengthening surveillance and maternal and child health actions. Method: This is a Professional Master’s Final Paper organized in a multipaper format, comprising one scientific production and one Technical-Technological Product. The scientific production was developed from three integrated methodological components: a retrospective analysis of operational data from the antenatal HTLV-1/2 testing strategy in the Federal District; a cross-sectional component with a questionnaire administered to women living with HTLV-1/2 diagnosed during antenatal care; and a cross-sectional study with children of women living with HTLV-1/2 to assess the occurrence of vertical transmission. The retrospective analysis considered data from the antenatal screening programme in the Federal District, focusing on operational aspects of testing, such as when the test was offered, turnaround time for screening results, time to confirmatory testing and completion of the testing strategy. The cross-sectional component with women aimed to characterize sociodemographic, clinical, healthcare and access-related aspects of vertical transmission prevention measures. The study with exposed children assessed HTLV infection and allowed evaluation of vertical transmission in the local context. Women diagnosed with HTLV-1/2 during antenatal care in the Federal District between 2013 and 2022 were eligible, identified through epidemiological surveillance records and the laboratory responsible for antenatal testing. Their children were also considered eligible, regardless of age, provided that consent for participation was obtained. Potential participants were contacted by a previously trained team using a standardized telephone script. Interviews and sample collection were scheduled at primary healthcare units according to the participants’ health region of residence. Before interviews and biological sample collection, applicable ethical procedures were carried out, including the reading and signing of informed consent and assent forms, when appropriate. The study was approved by a Research Ethics Committee. The variables analysed included characteristics of women, such as age, self-reported race/skin colour, education, family income, number of pregnancies, number of live-born children, timing of diagnosis, counselling received about HTLV, guidance on avoiding breastfeeding, use of lactation inhibitors, access to infant formula, partner serology and presence of HTLV cases in the family. Among children, variables included sex, age, race/skin colour, breastfeeding history, duration of breastfeeding, receipt of infant formula, previous HTLV testing and test result obtained during the study. Data analysis included descriptive statistics and evaluation of outcomes related to the occurrence of vertical transmission. The Technical-Technological Product was developed based on the epidemiological findings and the gaps identified in healthcare and surveillance practice. It consisted of a methodological study for the development and validation of educational health materials, conducted within the Health Department of the Federal District. Three materials were developed: an insert for the Pregnant Woman’s Handbook, an informational poster for healthcare facilities and a quick-reference desk prism guide for health professionals. The materials addressed information on HTLV, modes of transmission, prevention of vertical transmission, diagnosis, counselling, avoidance of breastfeeding, use of infant formula, follow-up of exposed children and organization of care within the health network. Validation was conducted with experts and women living with HTLV, using the Health Education Content Validation Instrument and the Suitability Assessment of Materials. The former assesses the domains of objectives, structure/presentation and relevance, while the latter evaluates the suitability of materials for the target audience, considering aspects such as clarity, organization, language, presentation and visual appeal. Products developed: The first product developed was the scientific manuscript entitled HTLV-1/2 Antenatal Screening in Distrito Federal, Brazil: Evaluation of Programme Implementation and Public Health Impact. The manuscript analyses the experience of the Federal District in implementing antenatal HTLV-1/2 screening and its effects on the prevention of vertical transmission. The analysis showed that programme implementation reduced vertical transmission from 10.2% to 0% among children born after maternal diagnosis and adoption of preventive measures. Most diagnosed women completed the diagnostic strategy by the second trimester of pregnancy, with a median turnaround time of seven days for screening test results and 12 days for confirmatory test results. Only 3.7% were diagnosed after delivery. Most diagnosed women formula-fed their children and received information on how to access free infant formula; however, only about half received formula before discharge from maternity care. Low coverage of HTLV testing among exposed children prior to the study was observed, indicating weaknesses in infant follow-up. The results demonstrate that the experience of the Federal District is relevant to guide the implementation of programmes aimed at eliminating HTLV vertical transmission in Brazil and in other contexts in the Americas, especially because it shows that timely diagnosis, combined with avoidance of breastfeeding, use of lactation inhibitors and provision of infant formula, can interrupt vertical transmission. In the updated document, the manuscript is presented in English and highlights the Federal District as a pioneering region with potential contributions to the national and regional response to HTLV. The second product was the Technical-Technological Product entitled Educational materials for the prevention of HTLV vertical transmission: strengthening care for pregnant women and health professionals. Three complementary educational materials were developed: an HTLV insert for the Pregnant Woman’s Handbook, containing information on the infection, modes of transmission and preventive measures; an informational poster for healthcare facilities, aiming to increase visibility of the topic and raise awareness among pregnant women, families and professionals; and a quick-reference desk prism guide for health professionals, containing flows and guidance on screening, diagnosis, counselling, prevention of vertical transmission, clinical management and follow-up of exposed children. The rationale for developing these materials was based on research findings that identified important gaps in counselling for pregnant women living with HTLV: some participants did not receive sufficient information about the infection, were not adequately advised about the contraindication of breastfeeding or did not have timely access to infant formula. Validation of the materials involved experts and women living with HTLV, using the Health Education Content Validation Instrument and the Suitability Assessment of Materials. All materials achieved a Content Validity Index of 0.80 or higher, indicating adequacy regarding content, language, presentation and applicability. Implementation of these materials within the Health Department of the Federal District has the potential to support counselling, strengthen continuing health education, standardize guidance, improve work processes and contribute to the prevention of HTLV vertical transmission. This project is aligned with the research line Quality of Adult Health Care. Conclusion: The experience of the Federal District demonstrates that antenatal HTLV screening, when linked to effective preventive measures, has the potential to reduce and interrupt vertical transmission of the virus. Timely diagnosis of pregnant women, recommendation to avoid breastfeeding, use of lactation inhibitors and provision of infant formula are key strategies for prevention. However, the findings also reveal relevant challenges for consolidating this policy, particularly regarding the quality of counselling, timely access to supplies in maternity care and laboratory and healthcare follow-up of exposed children. The method used is appropriate for the objective of a professional master’s degree, as it combines analysis of data from a real programme of the Brazilian Unified Health System, investigation with women and exposed children, and development of an educational product applied to practice. It also presents an innovative character by systematizing the pioneering experience of the Federal District in antenatal HTLV screening and by integrating scientific production with educational technologies aimed at improving care. The work has the potential to influence public policies, healthcare practices, surveillance actions and continuing education processes, especially in the context of national implementation of antenatal HTLV screening and goals for eliminating vertical transmission. The dissertation presents scientific, technological, social and innovation relevance by addressing a neglected infection that remains poorly visible to professionals, managers and the general population, and by producing local evidence capable of supporting public health decision-making. The manuscript contributes to the scientific community by presenting data on effectiveness, timeliness of diagnosis, infant feeding, access to formula and follow-up of exposed children. The Technical-Technological Product, in turn, has the potential to generate direct impact in the health network by providing validated materials to support professionals and users in the care process. Its applicability is local, as it was developed for the reality of the Health Department of the Federal District; regional and national, as it can be adapted to other Brazilian territories implementing HTLV screening; and international, as it is aligned with the agenda of the Americas for the elimination of vertical transmission. Dissemination of results to the scientific community, managers and health authorities may occur through manuscript submission, availability of educational materials and their incorporation into surveillance, care and continuing education strategies. Editor: Escola de Saúde Pública do Distrito Federal Tipo: Dissertação Thu, 27 Feb 2025 00:00:00 GMT https://repositoriobce.fepecs.edu.br/handle/123456789/1721 2025-02-27T00:00:00Z https://repositoriobce.fepecs.edu.br/handle/123456789/1719 Título: Association between moral distress and burnout syndrome at a Palliative Care Unit in federal district—Brazil Autor(es): Job, Andrea Maria Praciano; Santos, Helton Saulo Bezerra dos; Mendes Filho, Sérgio Rogério de Araújo; Santana, Alfredo Nicodemos da Cruz Abstract: Background: Healthcare professionals face stressful situations, especially in palliative care settings, where they are exposed to ethical dilemmas. This study aims to assess the association between moral distress and burnout syndrome among working at a Palliative Care Unit. Methods: This is a cross-sectional analytical observational study conducted in a specialized Palliative Care Unit in Brazil. Between June and November 2024, a questionnaire was applied to healthcare professionals, collecting sociodemographic data, the Measure of Moral Distress for Healthcare Professionals-Brazilian version (MMD-HP BR) and the OLdenburg Burnout Inventory (OLBI) scales. Results: A total of 100 healthcare professionals were included, with a mean age of 39.79±10.23 years. The majority were female (82%), physicians (24%), had no palliative care formation (79%) and worked for less than 11 years (75%). The MMD-HP BR scale ranged from 0 to 309 (median =98), while the OLBI scale ranged from 36 to 65 (median =49). Burnout was associated with age (coefficient β=−0.11, P=0.02) and the intention to leave the job (coefficient β=2.81, P=0.01); however, there was no statistically significant association between burnout and moral distress. Conclusions: There was no association between moral distress and burnout in our study. This may be due to the interdisciplinary nature of palliative care helping mitigate this impact. Nevertheless, the association between Burnout, professionals’ age, and the desire to leave their jobs highlights workforce overload. Broader studies are needed to enhance understanding and help to prevent and control these phenomena. Editor: Annals of Palliative Medicine Tipo: Artigo de Periódico Fri, 15 May 2026 00:00:00 GMT https://repositoriobce.fepecs.edu.br/handle/123456789/1719 2026-05-15T00:00:00Z https://repositoriobce.fepecs.edu.br/handle/123456789/1717 Título: Nota epidemiológica 029/2026 - perfil epidemiológico dos acidentes por animais peçonhentos no Distrito Federal entre 2015 e 2025 Autor(es): Gervásio, Gabriella Pereira; Amaral, Matheus Henrique de Lima Primeiro Orientador: Fernandes, Sérgio Eduardo Soares Editor: Fundação de Ensino e Pesquisa em Ciência da Saúde Tipo: Produto Técnico Tue, 14 Jul 2026 00:00:00 GMT https://repositoriobce.fepecs.edu.br/handle/123456789/1717 2026-07-14T00:00:00Z